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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

DAVID D COULTAS, MD
1606 W LAFAYETTE AVE
JACKSONVILLE, IL62650-3707
 Phone: 217-245-1421
 Fax: 217-243-1699
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for DAVID D COULTAS · (Male)

NPI Number 1902804495
Credentials MD
Entity Individual
Enumeration date 07/08/2005
Last updated 07/08/2007 - About 9 years ago
Sole proprietor 1 Not specified
Identifiers
IL Medicare (Unspecified) L70709
IL Medicare UPIN C45785
Hospital affiliation(s)
  • MEMORIAL MEDICAL CENTER - (Acute Care)
    701 N FIRST ST
    SPRINGFIELD, IL 62781
  • PASSAVANT AREA HOSPITAL - (Acute Care)
    1600 W WALNUT ST
    JACKSONVILLE, IL 62650
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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