Healthcare Provider Details

I. General information

NPI: 1679567119
Provider Name (Legal Business Name): WILLIAM R COLYER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 N MCCORD RD
TOLEDO OH
43615-1753
US

IV. Provider business mailing address

1250 RALSTON AVE SUITE 203A
DEFIANCE OH
43512-5311
US

V. Phone/Fax

Practice location:
  • Phone: 419-842-3000
  • Fax: 419-291-9883
Mailing address:
  • Phone: 419-783-6895
  • Fax: 419-782-9288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35080843
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35080843
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: