Provider Demographics
NPI:1487650305
Name:COLLEY, JOEL E (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:E
Last Name:COLLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13286
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-3286
Mailing Address - Country:US
Mailing Address - Phone:480-215-6819
Mailing Address - Fax:901-682-9316
Practice Address - Street 1:PO BOX 13286
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85267-3286
Practice Address - Country:US
Practice Address - Phone:480-215-6819
Practice Address - Fax:901-682-9316
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT101368207L00000X
OK39260207L00000X
TXE0861207L00000X
AZ15070207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ0000BGMKMedicare PIN
AZD36695Medicare UPIN
AZZ76860Medicare PIN