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1568217727 NPI number — MR. TERRENCE LAMONT COLBERT I

NPI Number: 1568217727
Health Care Provider/Practitioner: MR. TERRENCE LAMONT COLBERT I

Information about “1568217727” NPI (MR. TERRENCE LAMONT COLBERT I) exists in 1568217727 in HTML format HTML  |  1568217727 in plain Text format TXT  |  1568217727 in PDF (Portable Document Format) PDF  |  1568217727 in an XML format XML  formats.

NPI Number : 1568217727 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568217727",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COLBERT",
    "FirstName": "TERRENCE",
    "MiddleName": "LAMONT",
    "NamePrefix": "MR.",
    "NameSuffix": "I",
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "COLBERT",
    "OtherFirstName": "TERRY",
    "OtherMiddleName": "LAMONT",
    "OtherNamePrefix": "MR.",
    "OtherNameSuffix": null,
    "OtherCredential": "RCP",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "7514 S 68TH EAST PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TULSA",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "74133-3003",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "918-271-4388",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "744 W 9TH ST FL 5",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TULSA",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "74127-9907",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "918-932-3700",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/22/2024",
    "LastUpdateDate": "04/22/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2278G1100X",
        "TaxonomyName": "General Care Certified Respiratory Therapist",
        "LicenseNumber": "4119",
        "LicenseNumberStateCode": "OK",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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