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General NPI Number Information
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NPI Number | 1780979211
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Entity Type | Individual
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Provider Name | JEFFREY S. COLBURN MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 2030 HAMILTON PLACE BLVD STE 220
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6040
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Country | US
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Telephone | 423-892-4289
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Fax |
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Provider Business Mailing Address
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Address Line | 202 JENNIFER DR
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City | YORKTOWN
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State | VA
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Zip | 23693-3138
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Country | US
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Telephone | 205-529-7126
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 32025
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 50198
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 071481
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 50198
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101270308
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License Number State | VA
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