Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME23499 | FL |
NPI | 1033176425 |
---|---|
Provider Name | Dr. Tommy Mills Coffman |
First Address | Palm Springs, FL 33461-3045 |
Second Address | Palm Springs, FL 33461-3045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 10/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036043100 | (05) | FL |
D55757 | (02) |