| Doctor Name: | MR. JAMES S. COLBERT |
| NPI Number: | 1881946317 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 19076 E. 801 Rd. #5 Park Hill, OK - 74451 |
| Business Phone Number: | 9184585085 |
| Business Fax Number: | 9184585085 |
| Mailing Address: | 1101 S Muskogee Ave, #1883 TAHLEQUAH |
| State: | OK |
| Postal Code: | 744652890 |
| Phone Number: | 9184585085 |
| Fax Number: | 9184585085 |
| NPI Enumeration Date: | 10/08/2012 |
| NPI Last Update Date: | 10/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |