Healthcare Provider Details

I. General information

NPI: 1255326203
Provider Name (Legal Business Name): DR. JOSEPH K COLL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NNPTC CIR
GOOSE CREEK SC
29445-6314
US

IV. Provider business mailing address

110 NNPTC CIRCLE
GOOSE CREEK SC
29445
US

V. Phone/Fax

Practice location:
  • Phone: 843-794-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101233028
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number29726
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: