Healthcare Provider Details

I. General information

NPI: 1154755239
Provider Name (Legal Business Name): COLTON MEIER ST AMAND PH.D., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: COLTON LAWRENCE KEO-MEIER PH.D.

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1254
ONEONTA NY
13820-5254
US

IV. Provider business mailing address

PO BOX 1254
ONEONTA NY
13820-5254
US

V. Phone/Fax

Practice location:
  • Phone: 607-388-6400
  • Fax: 607-208-6058
Mailing address:
  • Phone: 607-388-6400
  • Fax: 607-208-6058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number36071
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number324133
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number31290
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number69857
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: