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Individual

DR. THOMAS L COLVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2106 LOOP RD STE A, WINNSBORO, LA 71295-3343
(318) 435-6363
(318) 435-4646
Mailing address
2106 LOOP RD STE A, WINNSBORO, LA 71295-3343
(318) 435-6363
(318) 435-4646

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.019859
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1387533
LA
05
1449571
LA
01
4371062
AETNA PROVIDER NUMBER
LA
01
L92021
VANTAGE PROVIDER NUMBER
LA
Enumeration date
02/23/2006
Last updated
03/17/2015
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