Healthcare Provider Details

I. General information

NPI: 1013304948
Provider Name (Legal Business Name): ELLEN HILL COLGAN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLEN HILL BERNARD

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18800 SCHNUCKS DR
WARRENTON MO
63383-1120
US

IV. Provider business mailing address

5139 MATTIS RD STE 102
SAINT LOUIS MO
63128-2250
US

V. Phone/Fax

Practice location:
  • Phone: 636-456-3413
  • Fax: 636-456-7238
Mailing address:
  • Phone: 314-909-1920
  • Fax: 314-909-1980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2018014219
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2018014219
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: