Coleman, Jason Kenneth
Coleman, Jason Kenneth is an sole proprietor health care provider with primary practice located at 3964 Goodman Rd E Suite 128, Southaven MS 38672-8761. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Coleman, Jason Kenneth can be contacted via phone (662) 893-7337.Contact Information
Primary practice address
3964 Goodman Rd E Suite 128
Southaven MS 38672-8761
Phone: (662) 893-7337
Fax: (662) 893-7881
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 3112-99 | Mississippi |
Profile Details
| NPI number | 1477665065 |
|---|---|
| LBN Legal business name | Coleman, Jason Kenneth |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477665065 | NPPES |
| Mississippi | MEDICAID | 00660436 |
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