Individual
JAMES G COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
18209 EULA MAE PKWY, CARLYLE, IL 62231-6407
(618) 594-3671
(618) 594-8058
Mailing address
2717 PIPER HILLS DR, BELLEVILLE, IL 62221-3457
(618) 593-3764
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004470
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085004470
ILLINOIS STATE LICENSE NUMBER
IL
Enumeration date
09/28/2012
Last updated
09/28/2012
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