Healthcare Provider Details

I. General information

NPI: 1366428195
Provider Name (Legal Business Name): COATS MEDICAL CLINIC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N JOHNSON STREET
COATS NC
27521
US

IV. Provider business mailing address

PO BOX 819
COATS NC
27521-0819
US

V. Phone/Fax

Practice location:
  • Phone: 910-897-6423
  • Fax: 910-897-2740
Mailing address:
  • Phone: 910-897-6423
  • Fax: 910-897-2740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNC

VIII. Authorized Official

Name: DR. LINDA MOORE ROBINSON
Title or Position: PRACTICE OWNER
Credential: MD
Phone: 910-897-6423