Provider Demographics
NPI:1003813353
Name:COATES, FREDERICK H JR (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:H
Last Name:COATES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 PASADENA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2925
Mailing Address - Country:US
Mailing Address - Phone:859-278-1316
Mailing Address - Fax:859-276-1574
Practice Address - Street 1:2416 REGENCY RD
Practice Address - Street 2:STE. 300
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2954
Practice Address - Country:US
Practice Address - Phone:859-278-1316
Practice Address - Fax:859-276-1574
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21689208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY611142277OtherBLUEGRASS FAMILY HEALTH
KYK010972OtherCHAMPUS
KY64216898Medicaid
KY611142277OtherUMWA
KY001466485005OtherUNITED HEALTHCARE
OH50002129OtherOHIO BWC
KY1177921OtherCHA
KY163663600OtherDOL
KY000000231468OtherANTHEM
KY50002129OtherPASSPORT
KY050090009OtherRAILROAD MCR
KY1177921OtherCHA
KY0366220Medicare PIN
KY64216898Medicaid