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General NPI Number Information
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NPI Number | 1366415754
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Entity Type | Individual
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Provider Name | MISTY J COLVIN MD
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 3870 W RIVER RD STE 126
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City | TUCSON
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State | AZ
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Zip | 85741-3080
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Country | US
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Telephone | 520-219-6616
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Fax | 520-742-6187
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Provider Business Mailing Address
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Address Line | 6200 N LACHOLLA AVENUE ATTN: INA/SHANNON URGENT CARE
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City | TUCSON
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State | AZ
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Zip | 85741
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Country | US
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Telephone | 520-631-4434
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 30841
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License Number State | AZ
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