Basic Information
| Provider Information | |||||||||
| NPI: | 1982682746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COATES | ||||||||
| FirstName: | JAY | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12357 | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309142357 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068639595 | ||||||||
| FaxNumber: | 7068688375 | ||||||||
| Practice Location | |||||||||
| Address1: | 3196 S MARYLAND PKWY STE 425 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891092318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068639595 | ||||||||
| FaxNumber: | 7068688375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2006 | ||||||||
| LastUpdateDate: | 04/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 79259 | GA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 981 | NV | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | 981 | NV | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0102X | 79259 | GA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | DR.0065148 | CO | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | OS17329 | FL | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | O-1298 | ID | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | 5101012745 | MI | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | 28370 | MS | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | 2020-04065 | NC | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | DO83370 | SC | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | 4158 | TN | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | T0068 | TX | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | 0102206370 | VA | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | 981 | NV | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
No ID Information.