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General NPI Number Information
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NPI Number | 1679682512
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Entity Type | Organization
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Legal Business Name | JAMES J COYLE, MD LLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 226 S WOODS MILL RD STE 35
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3662
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Country | US
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Telephone | 314-548-6860
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Fax | 314-944-0373
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Provider Business Mailing Address
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Address Line | 226 S WOODS MILL RD STE 35W
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3442
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Country | US
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Telephone | 314-994-0313
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Fax | 314-994-0373
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Authorized Official
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Title or Position | ACCTS MANAGER
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Name | HEATHER CLARK
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Credential |
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Telephone | 314-994-0313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 117979
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License Number State | MO
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