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General NPI Number Information
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NPI Number | 1588739890
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Entity Type | Individual
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Provider Name | KENT ALLEN COLBURN DO
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 222 22ND AVE N SUITE 100
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City | NASHVILLE
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State | TN
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Zip | 37203-1870
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Country | US
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Telephone | 615-916-3825
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Fax | 615-916-3826
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Provider Business Mailing Address
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Address Line | 1670 UPHAM DR
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City | COLUMBUS
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State | OH
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Zip | 43210-1250
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Country | US
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Telephone | 614-293-9600
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 34005379
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2157
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License Number State | TN
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