Provider Demographics
NPI:1669425336
Name:COATES, JOHN BOYD III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BOYD
Last Name:COATES
Suffix:III
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 1:195 HOSPITAL LOOP
Mailing Address - Street 2:STE 5
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-8495
Mailing Address - Country:US
Mailing Address - Phone:802-229-5498
Mailing Address - Fax:802-229-2229
Practice Address - Street 1:195 HOSPITAL LOOP
Practice Address - Street 2:STE 5
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-8495
Practice Address - Country:US
Practice Address - Phone:802-229-5498
Practice Address - Fax:802-229-2229
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420005278207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1600OtherRAILROAD
VT0004798Medicaid
1600OtherRAILROAD
VT0004798Medicaid