Doctor Name: | WILLIAM RICHARD COLBURN |
NPI Number: | 1003834540 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 18412 |
Business Practice Address: | 83 Wellness Way Benton, KY - 420257156 |
Business Phone Number: | 2705278601 |
Business Fax Number: | 2705279615 |
Mailing Address: | Po Box 636961, CINCINNATI |
State: | OH |
Postal Code: | 452636961 |
Phone Number: | 5139815130 |
Fax Number: | 5139815015 |
NPI Enumeration Date: | 07/17/2006 |
NPI Last Update Date: | 06/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 18412 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |