Healthcare Provider Details

I. General information

NPI: 1952456683
Provider Name (Legal Business Name): BRUCE H COYER PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 PASADENA DR
LEXINGTON KY
40503-2907
US

IV. Provider business mailing address

114 PASADENA DR
LEXINGTON KY
40503-2907
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-4316
  • Fax: 859-277-1867
Mailing address:
  • Phone: 859-276-4316
  • Fax: 859-277-1867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number27546
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number17480
License Number StateKY

VIII. Authorized Official

Name: DR. BRUCE H COYER
Title or Position: PRESIDENT
Credential: MD
Phone: 859-276-4316