1003061326 NPI number — DR. JOAN M. COLFER M.D.

Table of content: DR. JOAN M. COLFER M.D. (NPI 1003061326)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003061326 NPI number — DR. JOAN M. COLFER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLFER
Provider First Name:
JOAN
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KEPFORD
Provider Other First Name:
CARL
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1003061326
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 429
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34106-0429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-252-5332
Provider Business Mailing Address Fax Number:
239-774-5653

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3301 TAMIAMI TRAIL
Provider Second Line Business Practice Location Address:
COLLIER COUNTY GOVERNMENT CENTER - BUILDING H
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34106-0429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-252-5332
Provider Business Practice Location Address Fax Number:
239-774-5653
Provider Enumeration Date:
12/01/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2083P0901X , with the licence number:  ME 79867 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083P0901X , with the licence number: D0027059 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)