Individual
MR. JAMES DWIGHT COLLEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6242 E ARBOR AVE STE 107, MESA, AZ 85206-1309
(480) 897-8000
(480) 830-3690
Mailing address
PO BOX 748860, ATLANTA, GA 30374-1309
(480) 897-8000
(480) 830-3690
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5795
AZ
207V00000X
Obstetrics & Gynecology Physician
5795
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z0551
HEALTH NET
AZ
01
—
252403
AHCCCS
AZ
01
—
AZ0032440
BLUE CROSS/BLUE SHIELD
AZ
Enumeration date
10/16/2006
Last updated
06/26/2023
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