Basic Information
Provider Information
NPI: 1780847228
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COKER
FirstName: ADAM
MiddleName: DAVID
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8101 E LOWRY BLVD
Address2: STE 120
City: DENVER
State: CO
PostalCode: 802307195
CountryCode: US
TelephoneNumber: 3034383999
FaxNumber: 7204399500
Practice Location
Address1: 455 SHERMAN ST
Address2: STE 510
City: DENVER
State: CO
PostalCode: 802034400
CountryCode: US
TelephoneNumber: 3037448644
FaxNumber: 3037800787
Other Information
ProviderEnumerationDate: 07/03/2008
LastUpdateDate: 02/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X51011COY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
0417304305CO MEDICAID


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