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General NPI Number Information
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NPI Number | 1114082864
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Entity Type | Individual
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Provider Name | ROBERTA ELAINE COLEMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2201 GREENTREE N
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City | CLARKSVILLE
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State | IN
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Zip | 47129-8957
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Country | US
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Telephone | 812-283-2013
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Fax |
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Provider Business Mailing Address
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Address Line | 12215 BRIDGEWAY CT
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City | SELLERSBURG
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State | IN
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Zip | 47172-9672
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Country | US
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Telephone | 812-248-9079
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 01030086
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 20376
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License Number State | KY
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