1427115260

Everything you always wanted to know about MR. COULY D LOUIS PA 2 MR. COULY D LOUIS PA but were afraid to ask.

MR. COULY D LOUIS PA 2 MR. COULY D LOUIS PA

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Name Prefix Provider Other Last Name Provider Other Middle Name Provider Other First Name Provider Other Credential
MR. COULY D LOUIS PA 2 MR. COULY D LOUIS PA
Gender:
Male
Enumeration date:
2007-01-02
Last update date:
2014-11-20
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
363A00000X Physician Assistant NE 1052220 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 9316451564
Practice Location Address Telephone Number 9316451564
Mailing Address Fax Number 9316453842
Practice Location Address Fax Number 9316453842

Addresses

Type Address City State Postal Country
Mailing Address 2320 WILMA RUDOLPH BLVD CLARKSVILLE TN 0 TN
Practice Location Address 2320 WILMA RUDOLPH BLVD CLARKSVILLE TN 0 TN

Other NPI Records that share a phone number

NPI Name Address State City
1013092410 CARDEN, RONALD
Individual
2320 WILMA RUDOLPH BLVD. TN CLARKSVILLE
1265471932 OBERNUEFEMANN, TIMOTHY
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1346295425 KENT, STEPHEN
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1396784138 ELLIS, RANDALL
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1548346166 MARCO, JACQUELINE
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1598704355 SHIPPEN, WILLIAM
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1598727380 BUCKMAN, DAVID
Individual
2320 WILMA RUDOLPH BLVD. TN CLARKSVILLE
1649226606 AMBULATORY AND OCCUPATIONAL HE
Organization
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1851538177 GARTMAN, TRUMAN
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE

Other NPI Records that share an address

NPI Name Address State City
1043285539 CLARKSVILLE IMAGING CENTER LLC
Organization
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1265471932 OBERNUEFEMANN, TIMOTHY
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1346295425 KENT, STEPHEN
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1396784138 ELLIS, RANDALL
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1548346166 MARCO, JACQUELINE
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1598704355 SHIPPEN, WILLIAM
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1649226606 AMBULATORY AND OCCUPATIONAL HE
Organization
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE
1851538177 GARTMAN, TRUMAN
Individual
2320 WILMA RUDOLPH BLVD TN CLARKSVILLE