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General NPI Number Information
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NPI Number | 1639246267
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Entity Type | Individual
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Provider Name | ISAAC WESLEY COOTS PA
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 13313 N. MERIDIAN BUILDING D
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120
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Country | US
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Telephone | 405-755-4290
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Fax | 405-755-7773
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Provider Business Mailing Address
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Address Line | 13313 N. MERIDIAN BUILDING D
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120
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Country | US
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Telephone | 405-755-4290
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Fax | 405-755-7773
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1584
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License Number State | OK
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