Individual
GLENN STEPHEN COATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7910 W JEFFERSON BLVD STE 108, FORT WAYNE, IN 46804-4159
(260) 436-0800
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01076627A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201356910
—
IN
Enumeration date
05/24/2011
Last updated
03/31/2026
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