Healthcare Provider Details

I. General information

NPI: 1992739676
Provider Name (Legal Business Name): JOAN F COKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 FOULK ROAD SUITE 205
WILMINGTON DE
19803
US

IV. Provider business mailing address

700 PRIDES XING STE 200
NEWARK DE
19713-6109
US

V. Phone/Fax

Practice location:
  • Phone: 302-998-0300
  • Fax: 302-478-8069
Mailing address:
  • Phone: 302-998-0300
  • Fax: 302-543-8456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberC10008417
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: