Individual
JUSTIN MICHAEL COATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1163 CARRIAGE DR S, SOUTHAVEN, MS 38671-2330
(901) 550-3704
Mailing address
1163 CARRIAGE DR S, SOUTHAVEN, MS 38671-2330
(901) 550-3704
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
839145
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
C003238
AR
Other
Enumeration date
04/26/2018
Last updated
07/17/2023
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