Healthcare Provider Details

I. General information

NPI: 1972507705
Provider Name (Legal Business Name): RICHARD D. COATS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 NE RALPH POWELL RD STE D
LEES SUMMIT MO
64064-2369
US

IV. Provider business mailing address

3600 NE RALPH POWELL RD STE D
LEES SUMMIT MO
64064-2369
US

V. Phone/Fax

Practice location:
  • Phone: 816-675-0920
  • Fax:
Mailing address:
  • Phone: 816-675-0920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-40402
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2002012294
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number04-40402
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2002012294
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: