NPI Code Detail JSON Logo

1194777441 NPI number — KIRK W. COFRAN MD

NPI Number: 1194777441
Health Care Provider/Practitioner: KIRK W. COFRAN MD

Information about “1194777441” NPI (KIRK W. COFRAN MD) exists in 1194777441 in HTML format HTML  |  1194777441 in plain Text format TXT  |  1194777441 in PDF (Portable Document Format) PDF  |  1194777441 in an XML format XML  formats.

NPI Number : 1194777441 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194777441",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COFRAN",
    "FirstName": "KIRK",
    "MiddleName": "W.",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2520 BERT KOUNS LOOP",
    "SecondLineMailingAddress": "SUITE 102",
    "MailingAddressCityName": "SHREVEPORT",
    "MailingAddressStateName": "LA",
    "MailingAddressPostalCode": "71118-3130",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "318-688-0173",
    "MailingAddressFaxNumber": "318-632-5369",
    "FirstLinePracticeLocationAddress": "2520 BERT KOUNS LOOP",
    "SecondLinePracticeLocationAddress": "SUITE 102",
    "PracticeLocationAddressCityName": "SHREVEPORT",
    "PracticeLocationAddressStateName": "LA",
    "PracticeLocationAddressPostalCode": "71118-3130",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "318-688-0173",
    "PracticeLocationAddressFaxNumber": "318-632-5369",
    "EnumerationDate": "05/16/2006",
    "LastUpdateDate": "11/21/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "13472R",
        "LicenseNumberStateCode": "LA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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