Provider Demographics
NPI:1124123419
Name:COATES, DEBORAH L (DO)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:COATES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1074 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1522
Mailing Address - Country:US
Mailing Address - Phone:937-254-3988
Mailing Address - Fax:937-254-1005
Practice Address - Street 1:1074 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-1522
Practice Address - Country:US
Practice Address - Phone:937-254-3988
Practice Address - Fax:937-254-1005
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003893208VP0000X
OH34.003893207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0673614Medicaid
OHP00348846OtherRAILROAD MEDICARE
0867715Medicare PIN
OHP00348846OtherRAILROAD MEDICARE