# COLEMAN INSTITUTE- INDIANA PETER RICHARD COLEMAN SOLE MBR

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jeffersonville Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235450867
- **Authorized official:** STEVEN F SHIELDS (BILLING MANAGER)
- **Authorized official phone:** (804) 282-9133

## Contact information

- **Practice address:** 1035 WALL ST, SUITE 204, JEFFERSONVILLE, IN 47130-3612
- **Practice address phone:** (812) 288-8410
- **Practice address fax:** (812) 288-8409
- **Mailing address:** 1035 WALL ST, SUITE 204, JEFFERSONVILLE, IN 47130-3612
- **Mailing address phone:** (812) 288-8410
- **Mailing address fax:** (812) 288-8409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02001067A | IN | Yes |

## Other

- **Enumeration date:** 06/17/2010
- **Last updated:** 10/07/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1437214731 | — | IN |