Provider Demographics
NPI:1427028083
Name:COLKER, JOEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:L
Last Name:COLKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NORTH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4147
Mailing Address - Country:US
Mailing Address - Phone:413-499-8590
Mailing Address - Fax:413-499-6410
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8590
Practice Address - Fax:413-499-6410
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30486174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10034387OtherCDPHP
MAA55922OtherHARVARD PILGRIM HEALTHCAR
MAI22172OtherBCBSMA
MA2008157Medicaid
MA030486OtherTUFTS HEALTHPLAN
NY00536145Medicaid
MA11417OtherHEALTH NEW ENGLAND
NY365675OtherMVP
MA11417OtherHEALTH NEW ENGLAND
A55922Medicare UPIN