Healthcare Provider Details

I. General information

NPI: 1255337093
Provider Name (Legal Business Name): ARTHUR THOMPSON COLLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 PORTER DR
MIDDLEBURY VT
05753-8501
US

IV. Provider business mailing address

116 PORTER DR
MIDDLEBURY VT
05753-8501
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-9885
  • Fax: 802-388-7120
Mailing address:
  • Phone: 802-388-9885
  • Fax: 802-388-7120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0420011538
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: