Individual
DR. LANDON WAYNE COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8TH AVENUE & C STREET, SALT LAKE CITY, UT 84143-0001
(801) 408-1784
(801) 408-5196
Mailing address
PO BOX 30309, CHARLESTON, SC 29417-0309
(843) 554-9300
(843) 566-8780
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
364205-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36420512000001
REGENCE BCBS
UT
05
—
870326048001D5088
—
UT
Enumeration date
03/17/2006
Last updated
03/03/2008
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