Individual
MR. WYCHE TAYLOR COLEMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1633 MARVEL ST, COUSHATTA, LA 71019-9022
(318) 932-9980
(318) 932-9906
Mailing address
1633 MARVEL ST, COUSHATTA, LA 71019-9022
(318) 932-9980
(318) 932-9906
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
015031
LA
207Q00000X
Family Medicine Physician
Primary
015031
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303003
—
LA
Enumeration date
07/07/2005
Last updated
07/26/2023
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