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General NPI Number Information
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NPI Number | 1811268253
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Entity Type | Organization
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Legal Business Name | HENRY EARL COTMAN, M. D., P. A
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 01/17/2012
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Provider Practice Location Address
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Address Line | 6449 38TH AVE N SUITE C-3
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1655
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Country | US
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Telephone | 727-492-7335
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 383
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City | ST PETERSBURG
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State | FL
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Zip | 33731-0383
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Country | US
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Telephone | 727-492-7335
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. HENRY EARL COTMAN
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Credential | M. D.
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Telephone | 727-492-7335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME0019800
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License Number State | FL
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