Provider Demographics
NPI:1861585283
Name:COLEMAN, WILLIAM P III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:COLEMAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 CONLIN ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2123
Mailing Address - Country:US
Mailing Address - Phone:504-455-3180
Mailing Address - Fax:504-885-2512
Practice Address - Street 1:4425 CONLIN ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2123
Practice Address - Country:US
Practice Address - Phone:504-455-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA012791207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB63407Medicare UPIN
LA51851Medicare PIN