Healthcare Provider Details

I. General information

NPI: 1487650305
Provider Name (Legal Business Name): JOEL E. COLLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 13286
SCOTTSDALE AZ
85267-3286
US

IV. Provider business mailing address

PO BOX 13286
SCOTTSDALE AZ
85267-3286
US

V. Phone/Fax

Practice location:
  • Phone: 480-215-6819
  • Fax: 901-682-9316
Mailing address:
  • Phone: 480-215-6819
  • Fax: 901-682-9316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number101368
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number39260
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberE0861
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number15070
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: