Provider Demographics
NPI:1003207556
Name:COATES, KELLY (DVM)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:COATES
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 DUTCH VALLEY RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-5303
Mailing Address - Country:US
Mailing Address - Phone:404-873-1786
Mailing Address - Fax:404-873-1055
Practice Address - Street 1:593 DUTCH VALLEY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-5303
Practice Address - Country:US
Practice Address - Phone:404-873-1786
Practice Address - Fax:404-873-1055
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007509174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian