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NPI Code Detail

MEDICARE: AJ COTTINGHAM JR MD ,PLLC

MEDICARE: AJ COTTINGHAM JR MD ,PLLC
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
1207W00000XOphthalmology PhysicianG7466TX

General Provider Information

NPI Number : 1922300425
Entity Type Code : Organization
Provider Name (Legal Business Name) : AJ COTTINGHAM JR MD ,PLLC
Provider Business Mailing Address
First Line : 15900 LA CANTERA PKWY
Second Line : SUITE 19205
City : SAN ANTONIO
State : TX
Zip : 78256
Country : US
Telephone Number : 210-696-0101
Fax Number : 210-695-8172
Provider Business Practice Location Address
First Line : 15900 LA CANTERA PKWY
Second Line : SUITE 19205
City : SAN ANTONIO
State : TX
Zip : 78256-2422
Country : US
Telephone Number : 210-696-0101
Fax Number : 210-695-8172
Authorized Official
Title or Position : OPHTHALOMOGIST
Name : DR. ANDREW JACKSON COTTINGHAM JR.
Credential : M.D.
Telephone Number : 210-696-0101
Provider Enumeration Date : 12/03/2010
Last Update Date : 12/03/2010

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