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NPI Code Detail

MEDICARE: JAMES COTTRELL

MEDICARE: JAMES COTTRELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1275147977
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES COTTRELL
Provider Business Mailing Address
First Line : 2414 ACADIANA LN
Second Line :
City : SEABROOK
State : TX
Zip : 77586-8309
Country : US
Telephone Number : 801-473-3963
Fax Number : 801-797-1220
Provider Business Practice Location Address
First Line : 855 E 4800 S STE 100
Second Line :
City : MURRAY
State : UT
Zip : 84107-5513
Country : US
Telephone Number : 801-473-3963
Fax Number : 801-797-1220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2020
Last Update Date : 09/01/2020

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