Provider Demographics
NPI:1225537319
Name:JEANNETTE COLON, M.D., P.C.
Entity type:Organization
Organization Name:JEANNETTE COLON, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:COLON-MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-509-5218
Mailing Address - Street 1:401 WALL ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2585
Mailing Address - Country:US
Mailing Address - Phone:219-707-5772
Mailing Address - Fax:219-707-5758
Practice Address - Street 1:401 WALL ST UNIT A
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2585
Practice Address - Country:US
Practice Address - Phone:219-707-5772
Practice Address - Fax:219-707-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01075122A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty