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:
Health care specialties
| Specialty | Code | License # | 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 18 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 | 1477560530 | NPPES |
| Indiana | MEDICAID | 20232790A | |
| Indiana | Other | 0007332133 | |
| Indiana | MEDICAID | 1103006 | |
| Indiana | MEDICAID | 64320716 | |
| Indiana | Other | 000000065792 |
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