MEDICARE: FREDERICK H COATES JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	21689	KY
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	21689	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	611142277	OTHER	KY	BLUEGRASS FAMILY HEALTH
2	K010972	OTHER	KY	CHAMPUS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	611142277	OTHER	KY	UMWA
5	001466485005	OTHER	KY	UNITED HEALTHCARE
6	50002129	OTHER	OH	OHIO BWC
7	1177921	OTHER	KY	CHA
8	163663600	OTHER	KY	DOL
9	000000231468	OTHER	KY	ANTHEM
10	50002129	OTHER	KY	PASSPORT
11	050090009	OTHER	KY	RAILROAD MCR

General Provider Information

NPI Number	:	1003813353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK H COATES JR. M.D.

Provider Business Mailing Address
First Line	:	280 PASADENA DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2925
Country	:	US
Telephone Number	:	859-278-1316
Fax Number	:	859-276-1574

Provider Business Practice Location Address
First Line	:	2416 REGENCY RD
Second Line	:	STE. 300
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2954
Country	:	US
Telephone Number	:	859-278-1316
Fax Number	:	859-276-1574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	05/09/2016

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