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NPI Code Detail

MEDICARE: STEPHEN A COACHYS M.D.

MEDICARE: STEPHEN A COACHYS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician17784MS

General Provider Information

NPI Number : 1669420915
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN A COACHYS M.D.
Provider Business Mailing Address
First Line : 308 CORPORATE DR
Second Line :
City : RIDGELAND
State : MS
Zip : 39157-8803
Country : US
Telephone Number : 601-898-7500
Fax Number : 601-898-7577
Provider Business Practice Location Address
First Line : 5606 OLD CANTON RD
Second Line :
City : JACKSON
State : MS
Zip : 39211-4217
Country : US
Telephone Number : 601-957-3333
Fax Number : 601-957-3335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 09/15/2015

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Directions to “ STEPHEN A COACHYS M.D.” Practice Location

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