Provider Demographics
NPI:1427054758
Name:COKINGTIN, CLIFTON D (MD)
Entity type:Individual
Prefix:DR
First Name:CLIFTON
Middle Name:D
Last Name:COKINGTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5520 COLLEGE BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1658
Mailing Address - Country:US
Mailing Address - Phone:913-491-3737
Mailing Address - Fax:913-469-6686
Practice Address - Street 1:5520 COLLEGE BLVD
Practice Address - Street 2:STE 201
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1658
Practice Address - Country:US
Practice Address - Phone:913-491-3737
Practice Address - Fax:913-469-6686
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-24794207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS102258OtherBCBSKS
18344010OtherFREEDOM NETWORK
18344010OtherBCBSKC
3115147010OtherCIGNA
000314OtherFAMILY HEALTH PARTNERS
560000OtherFIRST GUARD
KS100138550DMedicaid
MO203405428Medicaid
KS100138550CMedicaid
0808020OtherUNITED HEALTHCARE
18344010OtherPHP
MO203405444Medicaid
4479577OtherAETNA
KS102258Medicare PIN