Physician Compare National (NPI:1043287352)

HEALTHCARE PROVIDER: JACK COATES JR. D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1043287352
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375718059
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111207000632
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COATES
	Individual professional last name
Provider First Name	JACK
	Individual professional first name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NATIONAL COLLEGE OF CHIROPRACTIC
	Individual professional's medical school
Graduation Year	1978
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	229 5TH ST
	Group Practice or individual's line 1 address
City	ELYRIA
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	440355721
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4403229096
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y