Individual
DR. ERASME COLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 N STATE OF FRANKLIN RD, STE 9, JOHNSON CITY, TN 37604-3645
(423) 926-4468
(423) 928-4838
Mailing address
701 N STATE OF FRANKLIN RD, STE 2, JOHNSON CITY, TN 37604-3645
(423) 926-4468
(423) 928-4838
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
049439
GA
207RC0000X
Cardiovascular Disease Physician
18820
SC
207RC0000X
Cardiovascular Disease Physician
Primary
54651
TN
207RI0011X
Interventional Cardiology Physician
18820
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060062892
MEDICARE RAILROAD
SC
01
—
11BDVMH
MEDICARE
GA
01
—
18820
STATE ID
SC
05
—
188200
—
SC
01
—
571109147
TAX ID
SC
01
—
F365496891
MEDICARE
SC
Enumeration date
03/08/2007
Last updated
02/12/2018
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