Provider Demographics
NPI:1417930660
Name:COLEMAN, RICHARD JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
Last Name:COLEMAN
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 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN551682085R0202X
AL231002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009911107Medicaid
AL266287Medicaid
AL51058852OtherBCBS
AL009920620Medicaid
AL239817Medicaid
AL244169Medicaid
AL244265Medicaid
AL51593006OtherBCBS
AL51058851OtherBCBS
AL89051541OtherBCBS
AL009920650Medicaid
AL009920640Medicaid
AL009942812Medicaid
AL126959Medicaid
AL244546Medicaid
AL51100036OtherBCBS
AL213427Medicaid
AL244450Medicaid
AL51058854OtherBCBS
AL51595467OtherBCBS
11453080OtherCAQH
AL244197Medicaid
AL244328Medicaid
TN3150515OtherBCBS
AL51521117OtherBCBS OF ALABAMA
AL009920630Medicaid
AL51058853OtherBCBS
AL51123773OtherBCBS