Provider Demographics
NPI:1548078579
Name:COLEMAN, LADONN C SR
Entity type:Individual
Prefix:
First Name:LADONN
Middle Name:C
Last Name:COLEMAN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 THAD ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-1521
Mailing Address - Country:US
Mailing Address - Phone:419-779-5675
Mailing Address - Fax:
Practice Address - Street 1:541 THAD ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-1521
Practice Address - Country:US
Practice Address - Phone:419-779-5675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker