Provider Demographics
NPI:1891959284
Name:COATS, CHAD M (OD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:M
Last Name:COATS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-4938
Mailing Address - Country:US
Mailing Address - Phone:270-781-2220
Mailing Address - Fax:270-781-2155
Practice Address - Street 1:952 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4938
Practice Address - Country:US
Practice Address - Phone:270-781-2220
Practice Address - Fax:270-781-2155
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1739DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist