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General NPI Number Information
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NPI Number | 1477575355
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Entity Type | Individual
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Provider Name | DENNIS KOLOKOLO MD
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Gender | Male
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 1616 W CUMBERLAND RD
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City | BLUEFIELD
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State | VA
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Zip | 24605-2005
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Country | US
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Telephone | 276-326-1618
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Fax | 276-326-1618
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Provider Business Mailing Address
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Address Line | 1145 S UTICA AVE STE 460
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City | TULSA
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State | OK
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Zip | 74104-4041
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Country | US
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Telephone | 918-579-5749
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Fax | 918-579-5762
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 27434
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD2022-0355
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101229030
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License Number State | VA
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