Colby Wang, MD, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

2001009509 Issued in MO

Legal business name

COLBY WANG, MD, LLC

Practice address

636 W Republic Rd
B-112
Springfield, MO 65807-5818

Phone

(417) 886-6067

NPI assigned

Sep 10, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Colby L Wang

Title

MD

Phone

(417) 886-6067

Specialties & licenses 1

Addresses

Other names 1

• Preventative Psychiatry Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1225463136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 W REPUBLIC RD",
            "address_2": "B-112",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075818",
            "telephone_number": "417-886-6067",
            "fax_number": "417-886-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 W REPUBLIC RD",
            "address_2": "B-112",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075818",
            "telephone_number": "417-886-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLBY WANG, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "COLBY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "417-886-6067"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MO",
            "license": "2001009509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preventative Psychiatry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brenton Raval Coger, M.D.
• Cognivantage, LLC
• Patricia E Cogswell, LPC
• Iran Neal Cohen, PHD
• Lori J Cohen, M.D.
• Elizabeth J Cole, MA, LPC
• Miranda K Cole, PT
• Phyllis Leigh Cole, PSY.D., LPC
• Rachelle L Colegrove
• Deshawn D Coleman, PLP

• Adolescent and Children Mental Health Clinic/Center in Springfield, MO
• Providers in Springfield, MO by specialty
• Adolescent and Children Mental Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.