Mccolley, Kenneth E

Mccolley, Kenneth E is an individual health care provider with primary practice located at 3700 S Main St , Blacksburg VA 24060-7017. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Allopathic & Osteopathic Physicians / Emergency Medicine. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Mccolley, Kenneth E can be contacted via phone (540) 953-5122.

Contact Information

Primary practice address
3700 S Main St Blacksburg VA 24060-7017
Phone: (540) 953-5122
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0110-840685 Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 0110840685 Virginia

Profile Details

NPI number 1003817966
LBN Legal business name Mccolley, Kenneth E
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Sep 22nd, 2010 - about 16 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 1003817966 NPPES
Virginia Other 0110840685 BOARD OF MEDICINE

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