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NPI Code Detail

MEDICARE: JASON D COLEMAN DC

MEDICARE:   JASON D COLEMAN  DC
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
1111N00000XChiropractorDC0000000175TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14066937OTHERTNBCBS

General Provider Information

NPI Number : 1871663773
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON D COLEMAN DC
Provider Business Mailing Address
First Line : 8132 CORDOVA RD
Second Line : SUITE 102
City : CORDOVA
State : TN
Zip : 38016-6005
Country : US
Telephone Number : 901-751-0939
Fax Number : 901-751-0332
Provider Business Practice Location Address
First Line : 8132 CORDOVA RD
Second Line : SUITE 102
City : CORDOVA
State : TN
Zip : 38016-6005
Country : US
Telephone Number : 901-751-0939
Fax Number : 901-751-0332
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 04/21/2011

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Directions to “ JASON D COLEMAN DC” Practice Location

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