Provider Demographics
NPI:1306918982
Name:COL MANAGEMENT LLC
Entity type:Organization
Organization Name:COL MANAGEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-291-9161
Mailing Address - Street 1:2526 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2019
Mailing Address - Country:US
Mailing Address - Phone:662-328-8402
Mailing Address - Fax:662-328-1554
Practice Address - Street 1:2526 5TH ST N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2019
Practice Address - Country:US
Practice Address - Phone:662-328-8402
Practice Address - Fax:662-328-1554
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COL MANAGEMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-15
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty