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NPI Code Detail

MEDICARE: MR. COLBY TATE STORM

MEDICARE: MR. COLBY TATE STORM
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
11710I1003XIndependent Duty Medical Technicians

General Provider Information

NPI Number : 1871438127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. COLBY TATE STORM
Provider Business Mailing Address
First Line : 5955 ATTU STREEET
Second Line :
City : MILLINGTON
State : TN
Zip : 38053
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8501 TANNER WILLIAMS RD
Second Line :
City : MOBILE
State : AL
Zip : 36608-8322
Country : US
Telephone Number : 251-441-6725
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2026
Last Update Date : 04/22/2026

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Directions to “ MR. COLBY TATE STORM ” Practice Location

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