Healthcare Provider Details

I. General information

NPI: 1720156607
Provider Name (Legal Business Name): COL MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 SEARGENT SOUTH PRENTISS DRIVE SUITE 100
NATCHEZ MS
39120
US

IV. Provider business mailing address

54 SEARGENT SOUTH PRENTISS DRIVE SUITE 100
NATCHEZ MS
39120
US

V. Phone/Fax

Practice location:
  • Phone: 601-442-2585
  • Fax: 601-442-6299
Mailing address:
  • Phone: 601-442-2585
  • Fax: 601-442-6299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES W HOLMES
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 337-291-9161