MEDICARE: JAY E COATES JR.

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
1	208600000X	Surgery Physician	79259	GA
2	2086S0102X	Surgical Critical Care Physician	981	NV
3	208600000X	Surgery Physician	981	NV
4	2086S0127X	Trauma Surgery Physician	28370	MS
5	2086S0127X	Trauma Surgery Physician	2020-04065	NC
6	2086S0127X	Trauma Surgery Physician	0102206370	VA
7	2086S0127X	Trauma Surgery Physician	4158	TN
8	2086S0127X	Trauma Surgery Physician	DO83370	SC
9	2086S0127X	Trauma Surgery Physician	T0068	TX
10	2086S0127X	Trauma Surgery Physician	DR.0065148	CO
11	2086S0127X	Trauma Surgery Physician	O-1298	ID
12	2086S0127X	Trauma Surgery Physician	OS17329	FL
13	2086S0127X	Trauma Surgery Physician	981	NV

General Provider Information

NPI Number	:	1982682746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY E COATES JR.

Provider Business Mailing Address
First Line	:	PO BOX 100744
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-0744
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3196 S MARYLAND PKWY STE 425
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2318
Country	:	US
Telephone Number	:	725-205-0725
Fax Number	:	725-204-5251

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	01/05/2023

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Directions to “ JAY E COATES JR. ” Practice Location

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