Basic Information
| Provider Information | |||||||||
| NPI: | 1689924177 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SARAH L COAKLEY, DO, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 76510 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809706510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196388844 | ||||||||
| FaxNumber: | 7196388115 | ||||||||
| Practice Location | |||||||||
| Address1: | 1615 MEDICAL CENTER PT | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809075788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196417614 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2012 | ||||||||
| LastUpdateDate: | 09/12/2012 | ||||||||
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| AuthorizedOfficialLastName: | COAKLEY | ||||||||
| AuthorizedOfficialFirstName: | SARAH | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7196417614 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 49232 | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.