Mattocks, Colleen James

Mattocks, Colleen James is an individual health care provider with primary practice located at 3707 Brambleton Ave , Roanoke VA 24018-3658. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Mattocks, Colleen James can be contacted via phone (540) 725-7800.

Contact Information

Primary practice address
3707 Brambleton Ave Roanoke VA 24018-3658
Phone: (540) 725-7800
Fax: (540) 725-7849
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 37742 South Carolina
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0102202851 Virginia

Profile Details

NPI number 1134387830
LBN Legal business name Mattocks, Colleen James
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2008
Last updated Dec 7th, 2020 - 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 1134387830 NPPES
Virginia Other VV2490A MEDICARE PTAN

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