Individual
DR. THADDEUS FRAZELL COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 WEST CLAY STREET, SYLACAUGA, AL 35150
(256) 249-8571
(256) 249-0314
Mailing address
PO BOX 66, 113 WEST CLAY STREET, SYLACAUGA, AL 35150
(256) 246-8511
(256) 249-0314
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
49142
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009943226
—
AL
01
—
50962
THE OATH
AL
01
—
51515335
BLUE CROSS BLUE SHIELD
AL
01
—
51515487
BLUE CROSS BLUE SHIELD
AL
01
—
51515488
BLUE CROSS BLUE SHIELD
AL
01
—
51515489
BLUE CROSS BLUE SHIELD
AL
Enumeration date
05/17/2006
Last updated
03/17/2008
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