| Colvin Medical Corporation | |
|
2106 Loop Rd Ste A Winnsboro LA 71295-3343 | |
| (318) 435-8020 | |
| Not Available |
| Full Name | Colvin Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 2106 Loop Rd Ste A, Winnsboro, Louisiana |
| Authorized Official Name and Position | Thomas L Colvin (OWNER) |
| Authorized Official Contact | 3184356363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colvin Medical Corporation 2106 Loop Rd Ste A Winnsboro LA 71295-3343 Ph: (318) 435-6363 | Colvin Medical Corporation 2106 Loop Rd Ste A Winnsboro LA 71295-3343 Ph: (318) 435-8020 |
| NPI Number | 1023152352 |
|---|---|
| Provider Enumeration Date | 02/19/2007 |
| Last Update Date | 09/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023152352 | NPI | - | NPPES |
| 439928784A | Other | LA | BCBS OF LA PROVIDER NO |
| 1449571 | Medicaid | LA | |
| 1982670733 | Other | LA | INDIVIDUAL NPI NUMBER |
| L92021 | Other | LA | VANTAGE PROVIDER NO |
| 4371062 | Other | LA | AETNA PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 109859 (Louisiana) | Primary |
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