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
Update your record
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