Colvin, Bradley C.

Colvin, Bradley C. is an individual health care provider with primary practice located at 9111 Susan Dr , Shreveport LA 71118-3136. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Colvin, Bradley C. can be contacted via phone (318) 212-5343.

Contact Information

Primary practice address
9111 Susan Dr Shreveport LA 71118-3136
Phone: (318) 212-5343
Fax: (318) 212-5360
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 024982 Louisiana

Profile Details

NPI number 1710956255
LBN Legal business name Colvin, Bradley C.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Jul 21st, 2022 - about 4 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 1710956255 NPPES
Louisiana MEDICAID 1422894

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