CLIFFORD LOREN COLEMAN M.D. NPI 1053492710

NPI Information

NPI: 1053492710
Provider Name: CLIFFORD LOREN COLEMAN, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
1155 CEDAR CT
CARBONDALE, IL
ZIP 62901
Phone: (618) 549-3388
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Clifford Loren Coleman, M.D. is a specialist in Carbondale, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Clifford Loren Coleman, M.D. NPI is 1053492710. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1155 CEDAR CT
CARBONDALE, IL
ZIP 62901-333
Phone: (618) 549-3388
Fax: (618) 549-3380

The enumeration date for this NPI number is 10/18/2006 and was last updated on 10/1/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		036060385	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036060385	MEDICAID	ILLINOIS
2	654350	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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