Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0101249015 | VA |
NPI | 1053549246 |
---|---|
Provider Name | Dr. Jeffrey Adam Colburn |
First Address | San Antonio, TX 78236-5638 |
Second Address | San Antonio, TX 78234-6200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 07/12/2021 |