MEDICARE: WILLIAM HENRY COLTHORPE MD

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
1	207R00000X	Internal Medicine Physician	0101284628	VA

General Provider Information

NPI Number	:	1639879505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM HENRY COLTHORPE MD

Provider Business Mailing Address
First Line	:	3551 ROGER BROOKE DRIVE
Second Line	:	SAMMC, MCHE-ZDE-M, INTERNAL MEDICINE RESIDENCY
City	:	JBSA-FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-292-7805
Fax Number	:	210-292-7868

Provider Business Practice Location Address
First Line	:	3551 ROGER BROOKE DRIVE
Second Line	:	SAMMC, MCHE-ZDE-M, INTERNAL MEDICINE RESIDENCY
City	:	JBSA-FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4504
Country	:	US
Telephone Number	:	210-292-7805
Fax Number	:	210-292-7868

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2023
Last Update Date	:	06/18/2026

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