Provider Demographics
NPI:1356352777
Name:COLEMAN, ROBERT JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:COLEMAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5500 E KELLOGG DR
Mailing Address - Street 2:ROBERT J DOLE VA MEDICAL CENTER
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1607
Mailing Address - Country:US
Mailing Address - Phone:316-681-2221
Mailing Address - Fax:316-681-5522
Practice Address - Street 1:5500 E KELLOGG DR
Practice Address - Street 2:ROBERT J DOLE VA MEDICAL CENTER
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1607
Practice Address - Country:US
Practice Address - Phone:316-681-2221
Practice Address - Fax:316-681-5522
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2010-02-24
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Provider Licenses
StateLicense IDTaxonomies
IL036091478208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery