Udall, Collin

Udall, Collin is an individual health care provider with primary practice located at 3048 E Baseline Rd Ste 109, Mesa AZ 85204-7287. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Udall, Collin can be contacted via phone (480) 632-1117.

Contact Information

Primary practice address
3048 E Baseline Rd Ste 109 Mesa AZ 85204-7287
Phone: (480) 632-1117
Fax: (480) 632-1118
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 15439 Arizona

Profile Details

NPI number 1861495434
LBN Legal business name Udall, Collin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Sep 13th, 2011 - about 13 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 1861495434 NPPES
Arizona Other AZ0878720 BLUE CROSS BLUE SHIELD
Arizona Other 1Z1014 BLUE CROSS BLUE SHIELD
Arizona Other 621104 BLUE CROSS BLUE SHIELD

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