Provider Demographics
NPI:1568217727
Name:COLBERT, TERRENCE LAMONT I
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:LAMONT
Last Name:COLBERT
Suffix:I
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:TERRY
Other - Middle Name:LAMONT
Other - Last Name:COLBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RCP
Mailing Address - Street 1:7514 S 68TH EAST PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3003
Mailing Address - Country:US
Mailing Address - Phone:918-271-4388
Mailing Address - Fax:
Practice Address - Street 1:744 W 9TH ST FL 5
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9907
Practice Address - Country:US
Practice Address - Phone:918-932-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK41192278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care