# DR. JACK COATES JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1043287352
- **Gender:** Man
- **Credential:** D.C.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 757 | OH | Yes |

## Other

- **Enumeration date:** 03/06/2006
- **Last updated:** 05/12/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000129647 | ANTHEM BC/BS | OH |
| 05 | — | 0405761 | — | OH |
| 01 | — | 1005721 | ASHN | OH |
| 01 | — | 10789858 | CAQH | OH |
| 01 | — | 341293302001 | MEDICAL MUTUAL | OH |
| 01 | — | 341293302003 | MEDICAL MUTUAL | OH |
| 01 | — | 34129330201 | WORKER'S COMP | OH |
| 01 | — | 341293302026 | CARESOURCE | OH |
| 01 | — | 350033709 | RAILROAD MEDICARE | OH |
| 01 | — | 367277 | WELLCARE | OH |
| 01 | — | 4332074 | AETNA | OH |