Coleman, Jack Andrew

Coleman, Jack Andrew is an individual health care provider with primary practice located at 1101-3 N. Progress Ave. , Siloam Springs AR 72761-4343. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Coleman, Jack Andrew can be contacted via phone (479) 549-4055.

Contact Information

Primary practice address
1101-3 N. Progress Ave. Siloam Springs AR 72761-4343
Phone: (479) 549-4055
Fax: (479) 549-4059
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD16783 Tennessee

Profile Details

NPI number 1699764258
LBN Legal business name Coleman, Jack Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated May 20th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1699764258 NPPES
Tennessee MEDICAID 3017988

Popular Providers