Provider Demographics
NPI:1710366539
Name:WARNOCK, COLIN GREGORY (AA-C)
Entity Type:Individual
Prefix:MR
First Name:COLIN
Middle Name:GREGORY
Last Name:WARNOCK
Suffix:
Gender:M
Credentials:AA-C
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1905 S DRUMM AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-1836
Mailing Address - Country:US
Mailing Address - Phone:816-204-0018
Mailing Address - Fax:
Practice Address - Street 1:1000 E PRIMROSE ST STE 520
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5180
Practice Address - Country:US
Practice Address - Phone:816-204-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant