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Organization

COLEMAN EYE CENTER, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TARA E KELLY (INSURANCE REPRESENTATIVE)
(662) 455-4523
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09015746
MS
01
4181580001
CIGNA GOVERNMENT SERVICES
MS
Enumeration date
07/12/2005
Last updated
07/21/2022
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