Provider Demographics
NPI:1174555320
Name:COY, JAMES S (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:COY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3725 W 4100 S
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120
Mailing Address - Country:US
Mailing Address - Phone:801-965-3600
Mailing Address - Fax:801-965-3526
Practice Address - Street 1:2751 W 9000 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088
Practice Address - Country:US
Practice Address - Phone:801-352-5900
Practice Address - Fax:801-352-5914
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT52806271204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000063200Medicare PIN
H90449Medicare UPIN