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NPI Code Detail

MEDICARE: DR. GARY RUBE COLEMAN D.M.D.

MEDICARE:  DR. GARY RUBE COLEMAN  D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry5147KY

General Provider Information

NPI Number : 1124132501
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY RUBE COLEMAN D.M.D.
Provider Business Mailing Address
First Line : 3008 MERIDETH CIR
Second Line :
City : LEXINGTON
State : KY
Zip : 40513-1725
Country : US
Telephone Number : 859-223-8299
Fax Number :
Provider Business Practice Location Address
First Line : 3708 WILLOW RIDGE RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40514-1562
Country : US
Telephone Number : 859-296-9252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GARY RUBE COLEMAN D.M.D.” Practice Location

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