Basic Information
| Provider Information | |||||||||
| NPI: | 1467883165 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCOLLUM | ||||||||
| FirstName: | DARRAGH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16540 HOPEWELL RD | ||||||||
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| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300042815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046447514 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11600 W 2ND PL | ||||||||
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| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203210000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2013 | ||||||||
| LastUpdateDate: | 12/05/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 0205572 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.