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General NPI Number Information
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NPI Number | 1992714042
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Entity Type | Individual
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Provider Name | JILL H COLVIN MD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 6 E CHESTNUT ST
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City | AUGUSTA
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State | ME
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Zip | 04330-5717
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Country | US
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Telephone | 207-623-6680
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Fax | 207-623-6609
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Provider Business Mailing Address
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Address Line | 6 E CHESTNUT ST
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City | AUGUSTA
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State | ME
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Zip | 04330-5717
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Country | US
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Telephone | 207-623-6680
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Fax | 207-623-6609
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 41818
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License Number State | WI
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