Healthcare Provider Details
I. General information
NPI: 1962430504
Provider Name (Legal Business Name): CHRISTOPHER M COLEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/30/2006
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7001 ROGERS AVE
FORT SMITH AR
72903-4073
US
IV. Provider business mailing address
PO BOX 3528
FORT SMITH AR
72913-3528
US
V. Phone/Fax
- Phone: 479-452-2077
- Fax:
- Phone: 479-452-2077
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | E-4316 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | E-4316 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: