Provider Demographics
NPI:1205005345
Name:KAREN A COATES O.D., INC.
Entity Type:Organization
Organization Name:KAREN A COATES O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-625-7904
Mailing Address - Street 1:4314 MILAN RD
Mailing Address - Street 2:UNIT 200
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-5897
Mailing Address - Country:US
Mailing Address - Phone:419-625-7904
Mailing Address - Fax:419-625-7833
Practice Address - Street 1:4314 MILAN RD
Practice Address - Street 2:UNIT 200
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5897
Practice Address - Country:US
Practice Address - Phone:419-625-7904
Practice Address - Fax:419-625-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4091/T37152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHKASP01301Medicare Oscar/Certification