Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | R9G23 | MO |
N | 207RP1001X | Pulmonary Disease | 04-24934 | KS |
Y | 207RP1001X | Pulmonary Disease | R9G23 | MO |
N | 207RS0012X | Sleep Medicine | R9G23 | MO |
NPI | 1023089349 |
---|---|
Provider Name | Quintin Lee Cokingtin |
First Address | Lees Summit, MO 64086-5696 |
Second Address | Lees Summit, MO 64086-5696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 28/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200374620A | (05) | KS |
203298401 | (05) | MO |
A28868 | (02) |