Provider Demographics
NPI:1750949152
Name:COATES, ZACHARY A (OD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:A
Last Name:COATES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:450 ALKYRE RUN STE 100
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-6910
Mailing Address - Country:US
Mailing Address - Phone:614-890-5692
Mailing Address - Fax:614-890-5629
Practice Address - Street 1:450 ALKYRE RUN STE 100
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6910
Practice Address - Country:US
Practice Address - Phone:614-890-5692
Practice Address - Fax:614-890-5629
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH006736152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist