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General NPI Number Information
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NPI Number | 1700988243
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Entity Type | Individual
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Provider Name | JOHN L COFFMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/04/2006
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 2301 S 56TH ST SUITE 110
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City | FORT SMITH
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State | AR
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Zip | 72903-3755
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Country | US
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Telephone | 479-452-1581
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Fax | 479-452-2184
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Provider Business Mailing Address
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Address Line | P O BOX 11880
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City | FORT SMITH
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State | AR
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Zip | 72917-1880
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Country | US
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Telephone | 479-452-1581
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Fax | 479-452-2184
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C8238
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License Number State | AR
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