Provider Demographics
NPI:1952456683
Name:BRUCE H COYER PSC
Entity Type:Organization
Organization Name:BRUCE H COYER PSC
Other - Org Name:COMMONWEALTH CARDIOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:COYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-276-4316
Mailing Address - Street 1:114 PASADENA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2907
Mailing Address - Country:US
Mailing Address - Phone:859-276-4316
Mailing Address - Fax:859-277-1867
Practice Address - Street 1:114 PASADENA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2907
Practice Address - Country:US
Practice Address - Phone:859-276-4316
Practice Address - Fax:859-277-1867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17480207RC0000X
KY27546207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65917288Medicaid
KY1875Medicare PIN
KYCM6661Medicare PIN