Provider Demographics
NPI:1275626962
Name:COATES, GRIFFIN RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:GRIFFIN
Middle Name:RAY
Last Name:COATES
Suffix:
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 1:2262 E PAGE MILL DR
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614
Mailing Address - Country:US
Mailing Address - Phone:423-260-4323
Mailing Address - Fax:
Practice Address - Street 1:15920 S RANCHO SAHUARITA BLVD STE 150
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-8014
Practice Address - Country:US
Practice Address - Phone:423-260-4323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32349208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA58-1997478OtherTIN
TN3003422Medicare ID - Type Unspecified
TNA96841Medicare UPIN