Goudelocke, Colin M

Goudelocke, Colin M is an individual health care provider with primary practice located at 1514 Jefferson Hwy , New Orleans LA 70121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Goudelocke, Colin M can be contacted via phone (504) 842-4083.

Contact Information

Primary practice address
1514 Jefferson Hwy New Orleans LA 70121
Phone: (504) 842-4083
Fax: (504) 842-6271
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 47657 Tennessee
Allopathic & Osteopathic Physicians / Urology 208800000X TL31990 South Carolina
Allopathic & Osteopathic Physicians / Urology 208800000X 201000 Louisiana
Allopathic & Osteopathic Physicians / Urology 208800000X 312724 Louisiana

Profile Details

NPI number 1164631149
LBN Legal business name Goudelocke, Colin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2007
Last updated Jun 19th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164631149 NPPES
Louisiana MEDICAID 07096

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