Ellis Morgan Collins Jr., M.D.
General Practice in Forrest City, AR. Individual provider (NPI-1).
NPI number1962647628
StatusActive
Last updated in NPPESDec 10, 2008
Details
- NPI
- 1962647628
- Entity type
- Individual (NPI-1)
- Name
- Ellis Morgan Collins Jr.
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 10, 2008
- Last updated
- Dec 10, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | C-2851 | AR | Yes |
| 207QA0505X | Family Medicine, Adult Medicine | C-2851 | AR |
Practice location
1301 E Broadway StForrest City, AR 72335-3922
Phone 870-633-5761 · Fax 870-633-5761
Mailing address
1301 E Broadway StForrest City, AR 72335-3922
Phone 870-633-5761 · Fax 870-633-5761
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