Organization
COLONIAL ORTHOPAEDICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BAILEY (CREDENTIALING SPECIALIST)
(804) 571-5106
Entity
Organization
Contact information
Practice address
13034 RIVERS BEND RD, CHESTER, VA 23836-2564
(804) 526-5888
(804) 526-5401
Mailing address
325 CHARLES H DIMMOCK PKWY STE 100, COLONIAL HEIGHTS, VA 23834-2986
(804) 571-5106
(804) 530-3015
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598084212
—
VA
Enumeration date
05/20/2010
Last updated
06/11/2019
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