Collis, Ricky Stanley

Collis, Ricky Stanley is an individual health care provider with primary practice located at 315 E Broadway Suite 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, Ricky Stanley can be contacted via phone (502) 589-4765.

Contact Information

Primary practice address
315 E Broadway Suite 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 29814 Kentucky

Profile Details

NPI number 1144231291
LBN Legal business name Collis, Ricky Stanley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Jul 10th, 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 1144231291 NPPES
Other 0005382490 AETNA
Other 000000043722 AETNA
MEDICAID 200137520A AETNA
MEDICAID 64298144 AETNA
MEDICAID 1058769 AETNA

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