# COLEMAN EYE CENTER, PLLC

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

## Provider details

- **NPI number:** 1528066644
- **Authorized official:** TARA E KELLY (INSURANCE REPRESENTATIVE)
- **Authorized official phone:** (662) 455-4523

## Contact information

- **Practice address:** 2005 HIGHWAY 82 W, GREENWOOD, MS 38930-2720
- **Practice address phone:** (662) 455-4523
- **Practice address fax:** (662) 455-3790
- **Mailing address:** 2005 HIGHWAY 82 W, GREENWOOD, MS 38930-2720
- **Mailing address phone:** (662) 455-4523
- **Mailing address fax:** (662) 455-3790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | MS | Yes |

## Other

- **Enumeration date:** 07/12/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09015746 | — | MS |
| 01 | — | 4181580001 | CIGNA GOVERNMENT SERVICES | MS |