Individual
WAYNE BRIAN COLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.D.
Contact information
Practice address
911 BYPASS RD BLDG A, PIKEVILLE, KY 41501-1689
(606) 430-2209
(606) 218-7509
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 430-2209
(606) 218-7509
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
34451
KY
207Y00000X
Otolaryngology Physician
Primary
34451
KY
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
34451
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040016970
RR MEDICARE PIN
GA
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64345416
—
KY
01
—
CB5773
RR MEDICARE GROUP
GA
Enumeration date
07/04/2006
Last updated
11/07/2022
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