Individual
CLINT M COLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 COLUMBINE DRIVE, HOLTON, KS 66436
(785) 364-2116
(785) 364-9613
Mailing address
1100 COLUMBINE DRIVE, HOLTON, KS 66436
(785) 364-2116
(785) 364-9613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-32089
KS
207Q00000X
Family Medicine Physician
0432089
KS
207Q00000X
Family Medicine Physician
6300
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104645
BLUE CROSS/BLUE SHIELD
KS
Enumeration date
02/23/2006
Last updated
06/30/2021
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