Individual
MALCOLM N COLBERT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1790 HAMILL RD, HIXSON, TN 37343-5179
(423) 362-4381
Mailing address
515 READ ST, EVANSVILLE, IN 47710-1739
(812) 437-1425
(812) 437-1435
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12126
TN
2251X0800X
Orthopedic Physical Therapist
05010267A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00417209
MEDICARE RAILROAD PTAN
—
Enumeration date
07/22/2006
Last updated
12/06/2018
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