Wyche T. Coleman, M.D., Limited

Key facts

NPI

1003984493

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

License

015031 (LA)

Legal business name

WYCHE T. COLEMAN, M.D., LIMITED

Practice address

1633 Marvel Street
Coushatta, LA 71019

Phone

(318) 932-9980

Fax

(318) 932-9906

NPI assigned

Dec 1, 2006

Organization subpart

No

Authorized official

Name

Wyche Taylor Coleman, M.D. NPI 1710984513

Title

Physician

Phone

(318) 932-9980

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wyche Taylor Coleman Jr., M.D. Family Medicine Physician · Coushatta, LA · NPI 1710984513
  Medicare reassignment Care Compare group NPD Authorized official FAMILY MEDICINE · LA
• Joshua Ray Cason, MD Family Medicine Physician · Coushatta, LA · NPI 1245466408
  Medicare reassignment Care Compare group NPD FAMILY MEDICINE · LA
• Sarah Herbel, MD Emergency Medicine Physician · Coushatta, LA · NPI 1508488024
  Medicare reassignment Care Compare group NPD FAMILY MEDICINE · LA
• Martin John Carter, MD Family Medicine Physician · Coushatta, LA · NPI 1487865937
  Medicare reassignment LA

Medicare participation

Medicare fee-for-service enrollment

Enrolled in LA

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003984493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 MARVEL STREET",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "71019",
            "telephone_number": "318-932-9980",
            "fax_number": "318-932-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 MARVEL STREET",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "71019",
            "telephone_number": "318-932-9980",
            "fax_number": "318-932-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYCHE T. COLEMAN, M.D., LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "WYCHE",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "318-932-9980",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "015031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447994",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coushatta, LA

• Jean Nicole Webb, FNP-C
• Western la Emergency Physicians
• Kassie Williams, PHARMD
• Anna Windham
• Sheila M Woodard, RN
• Mary Kate Young, NP

All providers in Coushatta, LA · Family Medicine Physician in Louisiana