Provider Demographics
NPI:1386159796
Name:KOLBAS, REBECCA ALLISON
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ALLISON
Last Name:KOLBAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 STANBROUGH DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-6501
Mailing Address - Country:US
Mailing Address - Phone:205-401-6162
Mailing Address - Fax:
Practice Address - Street 1:1800 HOWELL MILL RD NW STE 800
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-0922
Practice Address - Country:US
Practice Address - Phone:205-401-6162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN318996207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology