Healthcare Provider Details

I. General information

NPI: 1316515190
Provider Name (Legal Business Name): COLBY PRESLEY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W 98TH ST
BLOOMINGTON MN
55420-4773
US

IV. Provider business mailing address

600 W 98TH ST
BLOOMINGTON MN
55420-4773
US

V. Phone/Fax

Practice location:
  • Phone: 612-625-5656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number80074
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: