Goudelocke, Colin M
Goudelocke, Colin M is an individual health care provider with primary practice located at 1514 Jefferson Hwy , New Orleans LA 70121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Goudelocke, Colin M can be contacted via phone (504) 842-4083.Contact Information
Primary practice address
1514 Jefferson Hwy
New Orleans LA 70121
Phone: (504) 842-4083
Fax: (504) 842-6271
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 47657 | Tennessee |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | TL31990 | South Carolina |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 201000 | Louisiana |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 312724 | Louisiana |
Profile Details
| NPI number | 1164631149 |
|---|---|
| LBN Legal business name | Goudelocke, Colin M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2007 |
| Last updated | Jun 19th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164631149 | NPPES |
| Louisiana | MEDICAID | 07096 |
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