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Contact Information

WYCHE T COLEMAN III
2530 BERT KOUNS INDUSTRIAL LOOP STE 116
SHREVEPORT, LA71118-3153
 Phone: 318-212-5901
 Fax: 318-212-5905
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for WYCHE T COLEMAN III · (Male)

NPI Number 1841491826
Status Active
Credentials
Entity Individual
Enumeration date 05/29/2007
Last updated 06/22/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • LA License # MD.203333
  • LA Medicaid 09976
Hospital affiliation(s)
  • CHRISTUS COUSHATTA HEALTH CARE CENTER - (Critical Access)
    1635 MARVEL STREET
    COUSHATTA, LA 71019
  • NATCHITOCHES REGIONAL MEDICAL CENTER - (Acute Care)
    501 KEYSER AVE
    NATCHITOCHES, LA 71457
  • WILLIS KNIGHTON MEDICAL CENTER - (Acute Care)
    2600 GREENWOOD ROAD
    SHREVEPORT, LA 71103
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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