Healthcare Provider Details

I. General information

NPI: 1861982761
Provider Name (Legal Business Name): KRISTEN LEIGH COLEMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8020 LIBERTY WAY
WEST CHESTER OH
45069-2519
US

IV. Provider business mailing address

10506 MONTGOMERY RD STE 304
MONTGOMERY OH
45242-4400
US

V. Phone/Fax

Practice location:
  • Phone: 513-853-9000
  • Fax: 513-624-2964
Mailing address:
  • Phone: 513-853-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34.017403
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number5101027397
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number34.017403
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: