Provider Demographics
NPI:1851037139
Name:TAYLOR COLEMAN, MD, PLLC
Entity Type:Organization
Organization Name:TAYLOR COLEMAN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:769-487-5767
Mailing Address - Street 1:3000 OLD CANTON RD STE 305
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4245
Mailing Address - Country:US
Mailing Address - Phone:769-487-5767
Mailing Address - Fax:
Practice Address - Street 1:3000 OLD CANTON RD STE 305
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4245
Practice Address - Country:US
Practice Address - Phone:769-487-5767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty