MEDICARE: DR. DAVID JAMES COFFIN AU.D.

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
1	231H00000X	Audiologist	23002219A	IN

General Provider Information

NPI Number	:	1770561078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JAMES COFFIN AU.D.

Provider Business Mailing Address
First Line	:	BALL STATE UNIVERSITY
Second Line	:	2000 W. UNIVERSITY AVENUE
City	:	MUNCIE
State	:	IN
Zip	:	47306-0001
Country	:	US
Telephone Number	:	765-285-8160
Fax Number	:	765-285-5623

Provider Business Practice Location Address
First Line	:	BALL STATE UNIVERSITY
Second Line	:	2000 W. UNIVERSITY AVENUE
City	:	MUNCIE
State	:	IN
Zip	:	47306-0001
Country	:	US
Telephone Number	:	765-285-8160
Fax Number	:	765-285-5623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/08/2007

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