# WYCHE T. COLEMAN, M.D., LIMITED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003984493
- **Authorized official:** WYCHE TAYLOR COLEMAN M.D. (PHYSICIAN)
- **Authorized official phone:** (318) 932-9980

## Contact information

- **Practice address:** 1633 MARVEL STREET, COUSHATTA, LA 71019
- **Practice address phone:** (318) 932-9980
- **Practice address fax:** (318) 932-9906
- **Mailing address:** 1633 MARVEL STREET, COUSHATTA, LA 71019
- **Mailing address phone:** (318) 932-9980
- **Mailing address fax:** (318) 932-9906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 015031 | LA | Yes |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 08/22/2020