Provider Demographics
NPI:1316476161
Name:MUSSETT, COLBY (DPM)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:
Last Name:MUSSETT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 VIRGINIA OAKS DR STE 104
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3831
Mailing Address - Country:US
Mailing Address - Phone:703-743-5457
Mailing Address - Fax:703-454-5778
Practice Address - Street 1:7521 VIRGINIA OAKS DR
Practice Address - Street 2:STE 104
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3831
Practice Address - Country:US
Practice Address - Phone:703-743-5457
Practice Address - Fax:703-454-5778
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301297213EP1101X, 213ES0000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine