Mccollough, Martha Lynn

Mccollough, Martha Lynn is an individual health care provider with primary practice located at 1367 Dominion Plaza , Tyler TX 75703-1013. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Mccollough, Martha Lynn can be contacted via phone (903) 534-6200.

Contact Information

Primary practice address
1367 Dominion Plaza Tyler TX 75703-1013
Phone: (903) 534-6200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X J5401 Texas
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X J5401 Texas

Profile Details

NPI number 1972530954
LBN Legal business name Mccollough, Martha Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated May 22nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972530954 NPPES
Texas Other 85Z813 BLUE CROSS AND BLUE SHIELD PATHOLOGY
Texas MEDICAID 044554601 BLUE CROSS AND BLUE SHIELD PATHOLOGY
Texas Other 070012699 BLUE CROSS AND BLUE SHIELD PATHOLOGY
Texas Other 8A2686 BLUE CROSS AND BLUE SHIELD PATHOLOGY

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