BRADLEY C. COLVIN (NPI# 1710956255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710956255 |
| Entity Type | Individual |
| Full Name | BRADLEY C. COLVIN |
| Credential | MD |
| Practice Address |
9111 Susan Dr Shreveport LA 71118-3136 |
| Practice Telephone | (318) 212-5343 |
| Practice Fax Number | 3182125360 |
| Mailing Telephone | (318) 212-5343 |
| Mailing Fax Number | 3182125360 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2017-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 024982 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1422894 | 05 |
| Street Address |
9111 SUSAN DR |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467710087 | Monica Sehgal | Obstetrics & Gynecology | 9111 Susan Dr, Shreveport, LA 71118-3136 | 2012-05-02 |
| 1093093056 | Shanah Denise Walker | Nurse Practitioner | 9111 Susan Dr, Shreveport, LA 71118-3136 | 2011-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033554738 | Melissa Fett Jordan | Obstetrics & Gynecology | 3100 Fairfield Ave, Unit 10a, Shreveport, LA 71104-4152 | 2013-05-08 |
| 1285984823 | Wk Ob-gyn Concepts | Obstetrics & Gynecology | 7853 Youree Dr, Shreveport, LA 71105-5505 | 2012-09-11 |
| 1609985381 | Marsha Friedrich | Obstetrics & Gynecology | 1801 Fairfield Avenue Ste 207, Shreveport, LA 71101 | 2006-08-29 |
| 1164417309 | John W Waterfallen | Obstetrics & Gynecology | 7941 Youree Dr, Shreveport, LA 71105-5538 | 2005-09-14 |
| 1952306177 | Stephanie Ann Sockrider | Obstetrics & Gynecology | 8001 Youree Dr, Ste 900, Shreveport, LA 71115-2326 | 2005-06-15 |
| 1891181004 | Caitlin Favaloro Busada | Obstetrics & Gynecology | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2015-04-14 |
| 1689087355 | Wk Womens Specialists At South | Obstetrics & Gynecology | 2530 Bert Koun Loop, Suite 112, Shreveport, LA 71118-3132 | 2014-06-10 |
| 1629498902 | Lauren Deroche Harris | Obstetrics & Gynecology | 1501 Kings Hwy, Ob/gyn, Shreveport, LA 71103 | 2014-04-24 |
| 1952721946 | John Morgan | Obstetrics & Gynecology | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2014-04-17 |
| 1841634755 | Kilee Heard Lincoln | Obstetrics & Gynecology | 1501 Kings Hwy, Ob/gyn, Shreveport, LA 71103 | 2013-04-22 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
Please comment or provide details below to improve the information on BRADLEY C. COLVIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.