Provider Demographics
NPI:1417927815
Name:COMAN, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:COMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 S YALE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7804
Mailing Address - Country:US
Mailing Address - Phone:918-935-3350
Mailing Address - Fax:877-369-5351
Practice Address - Street 1:6465 S YALE AVE STE 202
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7804
Practice Address - Country:US
Practice Address - Phone:918-935-3350
Practice Address - Fax:877-369-5351
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19709174400000X, 207RC0001X
IDM-16168207RC0001X
ARE-7831207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100069600AMedicaid
AR163689001Medicaid
P00328724OtherMEDICARE RAILROAD
P00409618OtherMEDICARE RAILROAD
P00409618OtherMEDICARE RAILROAD
OK249620901Medicare PIN