Basic Information
| Provider Information | |||||||||
| NPI: | 1821131400 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SLEEP MEDICINE ASSOCIATES P. C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7307 E COLUMBIA ST | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477159141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124731737 | ||||||||
| FaxNumber: | 8124732432 | ||||||||
| Practice Location | |||||||||
| Address1: | 7307 E COLUMBIA ST | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477159141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124731737 | ||||||||
| FaxNumber: | 8124732432 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 01/11/2013 | ||||||||
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| AuthorizedOfficialLastName: | COCANOWER | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | ALLEN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8124731737 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | 500041148A | IN | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
No ID Information.