Healthcare Provider Details

I. General information

NPI: 1154391787
Provider Name (Legal Business Name): DAVID L COIL D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1953 WATERFALL DR
NAPPANEE IN
46550-8961
US

IV. Provider business mailing address

1953 WATERFALL DR
NAPPANEE IN
46550-8961
US

V. Phone/Fax

Practice location:
  • Phone: 574-773-4101
  • Fax: 574-773-5483
Mailing address:
  • Phone: 574-773-4101
  • Fax: 574-773-5483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02001877A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: