MEDICARE: GERALD O COATS MD

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	207R00000X	Internal Medicine Physician	33718	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114979879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD O COATS MD

Provider Business Mailing Address
First Line	:	13101 N ORACLE RD
Second Line	:	SUITE 157
City	:	TUCSON
State	:	AZ
Zip	:	85739-9554
Country	:	US
Telephone Number	:	520-818-5490
Fax Number	:	520-818-5488

Provider Business Practice Location Address
First Line	:	13101 N ORACLE RD
Second Line	:	SUITE 157
City	:	TUCSON
State	:	AZ
Zip	:	85739-9554
Country	:	US
Telephone Number	:	520-818-5490
Fax Number	:	520-818-5488

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/20/2013

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