Provider Demographics
NPI:1164473682
Name:COATNEY, MICHAEL W (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:COATNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:27 MONTEBELLO RD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1236
Mailing Address - Country:US
Mailing Address - Phone:719-545-1530
Mailing Address - Fax:719-545-2899
Practice Address - Street 1:27 MONTEBELLO RD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1236
Practice Address - Country:US
Practice Address - Phone:719-545-1530
Practice Address - Fax:719-545-2899
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26757207W00000X
NMA1218-03207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMP00125009OtherRAILROAD MEDICARE
COCO6757OtherEYEMED EYE CARE
CO92072402082OtherEYE SPECIALISTS
COK2018OtherANTHEM BCBS
NMNM004B11OtherNEW MEXICO BCBS
CO180008154OtherRAILROAD MEDICARE
NM0452890003OtherMEDICARE DMERC
CO608439600OtherUS DEPT OF LABOR WORK COM
NM85432067Medicaid
CO01267574Medicaid
CO0452890001OtherMEDICARE DMERC
COK2018OtherBCBS FEDERAL
CO608439600OtherUS DEPT OF LABOR WORK COM
CO0452890001OtherMEDICARE DMERC
NMNM004B11OtherNEW MEXICO BCBS