Provider Demographics
NPI:1699879072
Name:COLBERT, DANA L (DO)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:L
Last Name:COLBERT
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2106 N GOVERNMENT WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3543
Mailing Address - Country:US
Mailing Address - Phone:208-292-1315
Mailing Address - Fax:208-765-0627
Practice Address - Street 1:980 W IRONWOOD DR STE 201
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2668
Practice Address - Country:US
Practice Address - Phone:208-292-1315
Practice Address - Fax:208-765-0627
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2018-12-10
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Provider Licenses
StateLicense IDTaxonomies
IDO313207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDG59050Medicare UPIN