| Cofas Inc | |
|
2218 Shallock Ave Klamath Falls OR 97601-4290 | |
| (541) 882-3818 | |
| (541) 882-9800 |
| Full Name | Cofas Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2218 Shallock Ave, Klamath Falls, Oregon |
| Authorized Official Name and Position | Charles Keith Cofas (OWNER/MD) |
| Authorized Official Contact | 5418823818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cofas Inc 2218 Shallock Ave Klamath Falls OR 97601-4290 Ph: (541) 882-3818 | Cofas Inc 2218 Shallock Ave Klamath Falls OR 97601-4290 Ph: (541) 882-3818 |
| NPI Number | 1033179684 |
|---|---|
| Provider Enumeration Date | 03/27/2006 |
| Last Update Date | 05/16/2019 |
| Medicare PECOS PAC ID | 1456360114 |
|---|---|
| Medicare Enrollment ID | O20060410000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033179684 | NPI | - | NPPES |
| 027754 | Medicaid | OR | |
| DE8224 | Other | OR | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD11585 (Oregon) | Secondary |
| 207R00000X | Internal Medicine | MD25846 (Oregon) | Primary |
| 363A00000X | Physician Assistant | PA01446 (Oregon) | Secondary |
| Provider Name | Darcy R Butcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083614630 PECOS PAC ID: 0446282321 Enrollment ID: I20050831000818 |
| Provider Name | Charles K Cofas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053371666 PECOS PAC ID: 0143259648 Enrollment ID: I20060413000484 |
| Provider Name | Jon G Mckellar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275521916 PECOS PAC ID: 1254227580 Enrollment ID: I20080421000316 |
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