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Individual

KEITH A COLOMB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 BEAULLIEU DR., BLDG #5, LAFAYETTE, LA 70508-0000
(337) 267-4336
(337) 267-4167
Mailing address
200 BEAULLIEU DR., BLDG #5, LAFAYETTE, LA 70508-0000
(337) 267-4336
(337) 267-4167

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD019858
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1388122
LA
Enumeration date
03/17/2006
Last updated
11/12/2009
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