Colley, Johnny M
Colley, Johnny M is an individual health care provider with primary practice located at 1000 Pine St , Texarkana TX 75501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Colley, Johnny M can be contacted via phone (703) 701-0156.Contact Information
Primary practice address
1000 Pine St
Texarkana TX 75501
Phone: (703) 701-0156
Fax: (903) 793-7996
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | F3854 | Texas |
Profile Details
| NPI number | 1578562252 |
|---|---|
| LBN Legal business name | Colley, Johnny M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Oct 25th, 2013 - about 12 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 | 1578562252 | NPPES |
| Texas | MEDICAID | 09743 |
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