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General NPI Number Information
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NPI Number | 1295808202
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Entity Type | Organization
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Legal Business Name | COL MANAGEMENT, LLC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2526 5TH ST N
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City | COLUMBUS
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State | MS
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Zip | 39705-2019
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Country | US
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Telephone | 662-328-8402
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Fax | 662-328-1554
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Provider Business Mailing Address
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Address Line | 4906 AMBASSADOR CAFFERY PARKWAY BUILDING F
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City | LAFAYETTE
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State | LA
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Zip | 70508
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Country | US
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Telephone | 337-291-9161
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Fax | 337-289-0593
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | JAMES W. HOLMES
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Credential |
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Telephone | 337-291-9161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | MS
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