MEDICARE: DR. JAMES DEWAYNE COLQUITT 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
1	208600000X	Surgery Physician	041097	GA

General Provider Information

NPI Number	:	1750420006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DEWAYNE COLQUITT M.D.

Provider Business Mailing Address
First Line	:	35 COLLIER RD. NW
Second Line	:	STE 185
City	:	ATLANTA
State	:	GA
Zip	:	30309-1671
Country	:	US
Telephone Number	:	404-603-8100
Fax Number	:	404-603-8099

Provider Business Practice Location Address
First Line	:	35 COLLIER RD. NW
Second Line	:	STE 185
City	:	ATLANTA
State	:	GA
Zip	:	30309-1671
Country	:	US
Telephone Number	:	404-603-8100
Fax Number	:	404-603-8099

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	08/08/2016

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