MEDICARE: ROBERT S. COLEMAN PA-C

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
1	363A00000X	Physician Assistant	PA2126	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811447113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT S. COLEMAN PA-C

Provider Business Mailing Address
First Line	:	PO BOX 936
Second Line	:
City	:	LONDON
State	:	KY
Zip	:	40743-0936
Country	:	US
Telephone Number	:	606-330-7835
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 N EAGLE CREEK DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2121
Country	:	US
Telephone Number	:	859-264-9820
Fax Number	:	859-543-0994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2016
Last Update Date	:	02/16/2026

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