| David J. Colvin Md Llc | |
|
148 Waters Edge Dr Shreveport LA 71106-7774 | |
| (318) 797-1687 | |
| Not Available |
| Full Name | David J. Colvin Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 148 Waters Edge Dr, Shreveport, Louisiana |
| Authorized Official Name and Position | David J Colvin (OWNER) |
| Authorized Official Contact | 3187971687 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David J. Colvin Md Llc 148 Waters Edge Dr Shreveport LA 71106-7774 Ph: (318) 797-1687 | David J. Colvin Md Llc 148 Waters Edge Dr Shreveport LA 71106-7774 Ph: (318) 797-1687 |
| NPI Number | 1831402254 |
|---|---|
| Provider Enumeration Date | 07/15/2010 |
| Last Update Date | 07/15/2010 |
| Medicare PECOS PAC ID | 1658567987 |
|---|---|
| Medicare Enrollment ID | O20101129000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831402254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 022840 (Louisiana) | Primary |
| Provider Name | David Colvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023010592 PECOS PAC ID: 5496855793 Enrollment ID: I20070716000713 |
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