Basic Information
Provider Information
NPI: 1669818589
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COTTON
FirstName: COLLEEN
MiddleName: HELEN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 744785
Address2:  
City: ATLANTA
State: GA
PostalCode: 303744785
CountryCode: US
TelephoneNumber: 2024765000
FaxNumber:  
Practice Location
Address1: 111 MICHIGAN AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200102916
CountryCode: US
TelephoneNumber: 2024765000
FaxNumber: 2024764333
Other Information
ProviderEnumerationDate: 05/18/2013
LastUpdateDate: 10/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207NP0225XMD463986PAN Allopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
207NP0225X83016SCN Allopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
207NP0225XMD210002486DCY Allopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology

No ID Information.


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