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NPI Code Detail

MEDICARE: JAMES BRIAN COTNER MD

MEDICARE: JAMES BRIAN COTNER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianE1816AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25L434OTHERARARK BLUECROSS

General Provider Information

NPI Number : 1164482162
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES BRIAN COTNER MD
Provider Business Mailing Address
First Line : PO BOX 668
Second Line :
City : CLARKSVILLE
State : AR
Zip : 72830-0668
Country : US
Telephone Number : 479-754-9945
Fax Number : 479-754-9947
Provider Business Practice Location Address
First Line : 601 W MCKENNON ST
Second Line :
City : CLARKSVILLE
State : AR
Zip : 72830-3523
Country : US
Telephone Number : 479-754-8384
Fax Number : 479-754-7141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 06/17/2008

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