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General NPI Number Information
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NPI Number | 1487807483
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Entity Type | Organization
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Legal Business Name | COLBERT HEALTHCARE & PREVENTIVE WELLNESS, P.C.
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 7601 NATURAL BRIDGE RD SUITE 103
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City | SAINT LOUIS
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State | MO
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Zip | 63121-4904
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Country | US
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Telephone | 314-383-5221
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Fax | 314-383-5228
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Provider Business Mailing Address
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Address Line | 7601 NATURAL BRIDGE ROAD SUITE 103
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City | ST. LOUIS
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State | MO
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Zip | 63121
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Country | US
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Telephone | 314-383-5221
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Fax | 314-383-5228
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. DENNIS GREGORY COLBERT
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Credential | M.D.
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Telephone | 314-383-5221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | R8H27
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License Number State | MO
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