Provider Demographics
NPI:1801880539
Name:COFER, JOSEPH B (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:COFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:423-778-7000
Mailing Address - Fax:
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:STE 300
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-267-0466
Practice Address - Fax:423-778-8168
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD11700174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00693041AMedicaid
1740087OtherUHC
62165877403OtherJDH
4839507 002OtherCIGNA
E69250Medicare UPIN
3001977Medicare PIN
AL009603060Medicaid
TNQ002541Medicaid
185284OtherBCBS OF TN
020029185OtherRR MEDICARE
GA00693041AMedicaid
1740087OtherUHC