Provider Demographics
NPI:1710022637
Name:COIT, GREGORY R (OD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:R
Last Name:COIT
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:13384 CLINET DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-7638
Mailing Address - Country:US
Mailing Address - Phone:916-284-4520
Mailing Address - Fax:719-434-2287
Practice Address - Street 1:13384 CLINET DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-7638
Practice Address - Country:US
Practice Address - Phone:916-284-4520
Practice Address - Fax:719-434-2287
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2699152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0071650Medicare PIN
CA1015940001Medicare NSC
CAT10483Medicare UPIN