Provider Demographics
NPI:1750420006
Name:COLQUITT, JAMES DEWAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DEWAYNE
Last Name:COLQUITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:35 COLLIER RD. NW
Mailing Address - Street 2:STE 185
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1671
Mailing Address - Country:US
Mailing Address - Phone:404-603-8100
Mailing Address - Fax:404-603-8099
Practice Address - Street 1:35 COLLIER RD. NW
Practice Address - Street 2:STE 185
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1671
Practice Address - Country:US
Practice Address - Phone:404-603-8100
Practice Address - Fax:404-603-8099
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2016-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA041097208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA02BDFPLMedicare ID - Type Unspecified
GAG57960Medicare UPIN