Provider Demographics
NPI:1639117146
Name:MCCOLGAN, BRIAN PADRAIC (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PADRAIC
Last Name:MCCOLGAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 E ESTEVAN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-7211
Mailing Address - Country:US
Mailing Address - Phone:602-796-8641
Mailing Address - Fax:
Practice Address - Street 1:250 E. DUNLAP AVE
Practice Address - Street 2:ENVISION OFFICE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020
Practice Address - Country:US
Practice Address - Phone:602-943-2381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4538207P00000X
MI5101016300207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4538OtherOSTEOPATHIC PHYSICIAN LICENSE
MI5101016300OtherPHYSICIAN LICENSE