Provider Demographics
NPI:1881757383
Name:GLORIA B COKER, MD
Entity type:Organization
Organization Name:GLORIA B COKER, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-892-7130
Mailing Address - Street 1:71250 HENDRY AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8849
Mailing Address - Country:US
Mailing Address - Phone:985-892-7130
Mailing Address - Fax:985-626-6995
Practice Address - Street 1:71250 HENDRY AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8849
Practice Address - Country:US
Practice Address - Phone:985-892-7130
Practice Address - Fax:985-626-6995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5D258Medicare ID - Type Unspecified