Provider Demographics
NPI:1649204504
Name:COLNES, JEFFREY P (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:P
Last Name:COLNES
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 1:12 HOSPITAL DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1030
Mailing Address - Country:US
Mailing Address - Phone:207-363-6136
Mailing Address - Fax:207-363-4863
Practice Address - Street 1:12 HOSPITAL DR
Practice Address - Street 2:SUITE 9
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1030
Practice Address - Country:US
Practice Address - Phone:207-363-6136
Practice Address - Fax:207-363-4863
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME13294207RC0000X
NH8692207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80002088Medicaid
MEMM4163Medicare PIN
NHRE2088Medicare PIN
A66411Medicare UPIN