Basic Information
| Provider Information | |||||||||
| NPI: | 1831650886 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPLAINE-COTTON | ||||||||
| FirstName: | COURTNEY | ||||||||
| MiddleName: | DIPRISCO | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | MSC10 5550 1 UNIVERSITY OF NEW MEXICO | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052724661 | ||||||||
| FaxNumber: | 5052724601 | ||||||||
| Practice Location | |||||||||
| Address1: | 133 OLD ROAD TO 9 ACRE COR | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017424169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783691400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2019 | ||||||||
| LastUpdateDate: | 11/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | NM | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 292183 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.