Colquitt, Richard Derryl

Colquitt, Richard Derryl is an individual health care provider with primary practice located at 2300 W Charleston Blvd Ste 170, Las Vegas NV 89102. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Colquitt, Richard Derryl can be contacted via phone (702) 877-8683.

Contact Information

Primary practice address
2300 W Charleston Blvd Ste 170 Las Vegas NV 89102
Phone: (702) 877-8683
Fax: (702) 877-5249
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2329 Nevada

Profile Details

NPI number 1457328270
LBN Legal business name Colquitt, Richard Derryl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Feb 5th, 2008 - about 18 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 1457328270 NPPES
Nevada MEDICAID 2002076

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