Healthcare Provider Details

I. General information

NPI: 1801896741
Provider Name (Legal Business Name): JANET COYLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANET COYLE M.D.

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25117 HIGHWAY 15
UNION MS
39365-9088
US

IV. Provider business mailing address

550 DECATUR CARTHAGE RD
DECATUR MS
39327-9002
US

V. Phone/Fax

Practice location:
  • Phone: 601-774-8214
  • Fax: 601-774-9102
Mailing address:
  • Phone: 601-480-8316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0043074
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number43074
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number19451
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number052059
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: