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General NPI Number Information
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NPI Number | 1376630871
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Entity Type | Individual
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Provider Name | CAROL ANN COATS MD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 1107 HIGHWAY 395
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City | GARDNERVILLE
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State | NV
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Zip | 89410
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Country | US
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Telephone | 775-782-1615
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Fax | 775-782-1671
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Provider Business Mailing Address
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Address Line | 1111 EMERALD BAY ROAD
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150
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Country | US
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Telephone | 530-543-5644
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Fax | 530-541-8327
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6252
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License Number State | NV
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