Provider Demographics
NPI:1659463982
Name:COLEMAN, KAREN JOYCE (DO)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JOYCE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 272
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64640
Mailing Address - Country:US
Mailing Address - Phone:573-747-0022
Mailing Address - Fax:573-747-0055
Practice Address - Street 1:1101 WEBER RD SUITE 303
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:64640
Practice Address - Country:US
Practice Address - Phone:573-747-0022
Practice Address - Fax:573-747-0055
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001028976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A10577Medicare UPIN