Provider Demographics
NPI:1053412155
Name:COLEMAN, BARTON J (DC)
Entity type:Individual
Prefix:DR
First Name:BARTON
Middle Name:J
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 352
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:MO
Mailing Address - Zip Code:63073-0352
Mailing Address - Country:US
Mailing Address - Phone:314-239-6636
Mailing Address - Fax:
Practice Address - Street 1:605 N COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MO
Practice Address - Zip Code:63077-1103
Practice Address - Country:US
Practice Address - Phone:636-629-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2062481OtherFIRST HEALTH
MO350052143OtherRAILROAD MEDICARE
MO4401304OtherUHC
MO132120OtherBCBS
MO5358637OtherAETNA
MO5563633OtherCIGNA
MO394284OtherHEALTHLINK
MO4430008OtherMEDICARE COMPLETE
MO65360OtherGHP
MO394284OtherHEALTHLINK
MO00031615Medicare PIN