Collis, Dean Stanley

Collis, Dean Stanley is an individual health care provider with primary practice located at 315 E Broadway Ste 250, Louisville KY 40202-3700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Collis, Dean Stanley can be contacted via phone (502) 589-4765.

Contact Information

Primary practice address
315 E Broadway Ste 250 Louisville KY 40202-3700
Phone: (502) 589-4765
Fax: (502) 589-4799
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 32071 Kentucky

Profile Details

NPI number 1477560530
LBN Legal business name Collis, Dean Stanley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Jun 12th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477560530 NPPES
Indiana MEDICAID 20232790A
Indiana Other 0007332133
Indiana MEDICAID 1103006
Indiana MEDICAID 64320716
Indiana Other 000000065792

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