Individual
BRANDON L COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. O.
Contact information
Practice address
1016 HIGHWAY 42, SUMRALL, MS 39482-9634
(601) 758-4214
(601) 758-0614
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-0231
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17409
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125342
—
MS
01
—
1043492770
FIRST CHOICE OF MISSISSIPPI
MS
01
—
1143078
CAQH ID NUMBER
MS
01
—
2086469
UNITED HEALTH CARE
MS
01
—
405915
WINDSOR HEALTH GROUP
MS
01
—
7034349
AETNA
MS
01
—
71590-B
HUMANA/TRICARE
MS
01
—
8048940P04
CIGNA
MS
01
—
P00157321
RAILROAD MEDICARE
MS
Enumeration date
10/31/2005
Last updated
03/19/2024
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