Carl Lee Coogle
Individual provider Active NPI Private Vehicle · Fredericktown, OH
NPI 1124621545 · NPPES record last updated Nov 18, 2020
Key facts
- NPI
- 1124621545
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Private Vehicle 347C00000X
- License
- RS890181 (OH)
- Practice address
- 18933 Pinkley Rd
Fredericktown, OH 43019-9363 - Phone
- (740) 390-9746
- NPI assigned
- Nov 18, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RS890181 | OH | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | RS890181 | OH | Yes |
Addresses
Primary practice location
18933 Pinkley Rd
Fredericktown, OH 43019-9363
Mailing address
18933 Pinkley Rd
Fredericktown, OH 43019-9363
Phone (740) 390-9746
Other providers in Fredericktown, OH
- Joyce A Brake
- Robert Eric Burns
- Jennnifer T Butler
- Cassandra Lynn Byers
- Stephanie Campbell
- Melissa Cook
- Rebekah H Crawford
- Richard Scott Davis
- Lisa K Dilts
- Mary Bowlus Elder
All providers in Fredericktown, OH · Private Vehicle in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.