Collins, Larry L
Collins, Larry L is an individual health care provider with primary practice located at 6250 Old Canton Rd Suite 100, Jackson MS 39211-2946. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Collins, Larry L can be contacted via phone (601) 957-1015.Contact Information
Primary practice address
6250 Old Canton Rd Suite 100
Jackson MS 39211-2946
Phone: (601) 957-1015
Fax: (601) 956-9721
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 09096 | Mississippi |
Profile Details
| NPI number | 1164491924 |
|---|---|
| LBN Legal business name | Collins, Larry L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2006 |
| Last updated | Apr 20th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164491924 | NPPES |
| Mississippi | Other | 753068151003 | TRICARE |
| Mississippi | MEDICAID | 00011793 | TRICARE |
| Mississippi | Other | P00072975 | TRICARE |
| Mississippi | Other | 4405163 | TRICARE |
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