Provider Demographics
NPI:1053439489
Name:COLALUCA, JOHN ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:COLALUCA
Suffix:
Gender:M
Credentials:DO
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 85050
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23285-5050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:898 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1407
Practice Address - Country:US
Practice Address - Phone:317-887-1348
Practice Address - Fax:317-882-1631
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102203803207RA0401X
LA021805207RA0401X
IN020055262A207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine