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NPI Code Detail

MEDICARE: ZACHARY COLBAUGH M.D.

MEDICARE: ZACHARY COLBAUGH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianMD.35407AL
2207L00000XAnesthesiology Physician91545GA

General Provider Information

NPI Number : 1205215019
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY COLBAUGH M.D.
Provider Business Mailing Address
First Line : 1488 JESSE JEWELL PKWY SE STE 201
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3804
Country : US
Telephone Number : 770-532-7179
Fax Number :
Provider Business Practice Location Address
First Line : 743 SPRING ST NE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3899
Country : US
Telephone Number : 770-532-7179
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2015
Last Update Date : 07/13/2022

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