Healthcare Provider Details

I. General information

NPI: 1801872486
Provider Name (Legal Business Name): DAVID ALLEN COOLMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 BELLE CHASSE HIGHWAY
GRETNA LA
70121
US

IV. Provider business mailing address

1329 SW 16TH ST RM 2232
GAINESVILLE FL
32608-1128
US

V. Phone/Fax

Practice location:
  • Phone: 504-391-5157
  • Fax:
Mailing address:
  • Phone: 352-559-5051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME129629
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD2012-0026
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD.206687
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: