Ernest L Coburn Jr., MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

0101023208 Issued in VA

Practice address

315 Falls Dr NW
Abingdon, VA 24210-8093

Phone

(276) 739-7989

NPI assigned

Aug 9, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Imaging International PC

  • Diagnostic Radiology Physician
  • Abingdon, VA
  • NPI 1871774703
  NPD (past) Authorized official
• Abingdon Radiology Services LTD

  • Diagnostic Radiology Physician
  • Abingdon, VA
  • NPI 1629011341
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1164423745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 FALLS DR NW",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242108093",
            "telephone_number": "276-739-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 FALLS DR NW",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242108093",
            "telephone_number": "276-739-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "ERNEST",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "19885",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101023208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64096902",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olena Chuzhyk, MD
• Cheryl A. Clayton, L.C.S.W.
• Catherine Click, DOCTOR OF PHARMACY
• Clinch River Pediatric Dentistry PLLC
• Donald Matthew Cobb, D.O.
• Amanda Jo Cole, LPC
• Christopher Trent Cole, DPT
• Randolph Robinson Cole, M.D.
• Eric Thomas Coley, PT, ATC, CSCS
• Caroline Collard, DO

• Diagnostic Radiology Physician in Abingdon, VA
• Providers in Abingdon, VA by specialty
• Diagnostic Radiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.