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
325 CHARLES DIMMOCK PARKWAY, SUITE 301, COLONIAL HEIGHTS, VA 23834
(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
Primary
0101034297
VA
207X00000X
Orthopaedic Surgery Physician
0101036726
VA
207XS0106X
Orthopaedic Hand Surgery Physician
0101226595
VA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
0101231604
VA
207XS0117X
Orthopaedic Surgery of the Spine Physician
0101237849
VA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
0101045456
VA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
0101052925
VA
208100000X
Physical Medicine & Rehabilitation Physician
0101222130
VA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
0101235833
VA
208VP0014X
Interventional Pain Medicine Physician
0101224513
VA
213E00000X
Podiatrist
0103000995
VA
225100000X
Physical Therapist
2305005628
VA
225200000X
Physical Therapy Assistant
2306601247
VA
225XH1200X
Hand Occupational Therapist
0119000261
VA
363A00000X
Physician Assistant
0110003073
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811311343
—
VA
Enumeration date
02/04/2014
Last updated
06/11/2019
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