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NPI Code Detail

MEDICARE: MR. PAUL ALLEN COLEMAN PA-C

MEDICARE: MR. PAUL ALLEN 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
1363A00000XPhysician Assistant9900MN

Other Identifiers

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

General Provider Information

NPI Number : 1831152289
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL ALLEN COLEMAN PA-C
Provider Business Mailing Address
First Line : 1431 PREMIER DR
Second Line :
City : MANKATO
State : MN
Zip : 56001-6076
Country : US
Telephone Number : 507-386-6600
Fax Number : 507-625-5971
Provider Business Practice Location Address
First Line : 1095 HIGHWAY 15 S
Second Line :
City : HUTCHINSON
State : MN
Zip : 55350-5000
Country : US
Telephone Number : 320-484-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2006
Last Update Date : 07/22/2011

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