Provider Demographics
NPI:1861148140
Name:KOLBE, AUSTIN M (MD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:M
Last Name:KOLBE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:WILFORD HALL AMBULATORY SURGICAL CENTER
Mailing Address - Street 2:1100 WILFORD HALL LOOP, BLDG 4554, 59 MDW/GME
Mailing Address - City:JBSA LACKLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78263-9908
Mailing Address - Country:US
Mailing Address - Phone:210-916-9928
Mailing Address - Fax:210-916-9332
Practice Address - Street 1:JBSA-RANDOLPH CLINIC
Practice Address - Street 2:221 THIRD ST WEST, BLDG 104
Practice Address - City:JBSA
Practice Address - State:TX
Practice Address - Zip Code:78148
Practice Address - Country:US
Practice Address - Phone:210-652-4264
Practice Address - Fax:301-235-1678
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2024-08-09
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Provider Licenses
StateLicense IDTaxonomies
171000000X
NE36002208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No171000000XOther Service ProvidersMilitary Health Care Provider