Provider Demographics
NPI:1801979075
Name:CHARLES D COFFEY MD PC
Entity type:Organization
Organization Name:CHARLES D COFFEY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-532-1888
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-0205
Mailing Address - Country:US
Mailing Address - Phone:256-532-1888
Mailing Address - Fax:256-532-3941
Practice Address - Street 1:40 MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:MOULTON
Practice Address - State:AL
Practice Address - Zip Code:35650-1256
Practice Address - Country:US
Practice Address - Phone:256-974-0606
Practice Address - Fax:256-974-4530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty