Individual provider · NPI-1

Michael G Kolcun, MD

Emergency Medicine · Port Arthur, TX

NPI number1124078498
StatusActive
Last updated in NPPESJul 11, 2011

Details

NPI
1124078498
Entity type
Individual (NPI-1)
Name
Michael G Kolcun
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
May 10, 2006
Last updated
Jul 11, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency MedicineG0453TXYes

Practice location

2555 Jimmy Johnson Blvd
Port Arthur, TX 77640-2007

Phone 409-724-7389

Mailing address

Po Box 8730
Fort Worth, TX 76124-0730

Phone 817-451-4208

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