Individual
MR. JOEL WAYNE COOTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS,PA-C
Contact information
Practice address
2301 N BENDIX DR, SOUTH BEND, IN 46628-3486
(574) 647-1675
(574) 232-5595
Mailing address
58 TOLSTOY TRL, VALPARAISO, IN 46383-8937
(219) 707-5443
(219) 707-5443
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001120A
IN
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
08/02/2006
Last updated
11/17/2015
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