Provider Demographics
NPI:1811095862
Name:COYLE, JOHN JEROME JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JEROME
Last Name:COYLE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:935 GRENVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-2594
Mailing Address - Country:US
Mailing Address - Phone:818-425-3698
Mailing Address - Fax:
Practice Address - Street 1:935 GRENVILLE CIR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-2594
Practice Address - Country:US
Practice Address - Phone:818-425-3698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG445402085N0904X, 207U00000X, 207UN0903X, 207UN0901X, 207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No207UN0903XAllopathic & Osteopathic PhysiciansNuclear MedicineIn Vivo & In Vitro Nuclear Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy