Provider Demographics
NPI:1760523310
Name:COLBY, JOHN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:COLBY
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 1:2900 LAMB CIR STE 202
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-6480
Mailing Address - Country:US
Mailing Address - Phone:540-731-4578
Mailing Address - Fax:540-731-0867
Practice Address - Street 1:2900 LAMB CIR STE 202
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073
Practice Address - Country:US
Practice Address - Phone:540-731-4578
Practice Address - Fax:540-731-0867
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236532207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010097061Medicaid
VA145140OtherANTHEM
VA425133OtherSOUTHERN HEALTH
VA010092973Medicaid
VA010092973OtherVA PREMIER
VA425133OtherSOUTHERN HEALTH
VA010097061Medicaid