Healthcare Provider Details

I. General information

NPI: 1487603742
Provider Name (Legal Business Name): REBEKAH J COTE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W ELK AVE
ELIZABETHTON TN
37643-2654
US

IV. Provider business mailing address

1500 W ELK AVE
ELIZABETHTON TN
37643-2654
US

V. Phone/Fax

Practice location:
  • Phone: 423-543-2584
  • Fax: 423-722-2060
Mailing address:
  • Phone: 423-543-2584
  • Fax: 423-722-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMTL-2023-035
License Number StateGU
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO1230
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: