Provider Demographics
NPI:1285139311
Name:COGGINS, KATY ANNA (MD)
Entity type:Individual
Prefix:DR
First Name:KATY
Middle Name:ANNA
Last Name:COGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W BROADWAY APT 226
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53713-1831
Mailing Address - Country:US
Mailing Address - Phone:972-489-2021
Mailing Address - Fax:
Practice Address - Street 1:800 W BROADWAY APT 226
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53713-1831
Practice Address - Country:US
Practice Address - Phone:972-489-2021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI80125-20207W00000X
390200000X
COTL.0007169390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program