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General NPI Number Information
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NPI Number | 1457596157
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Entity Type | Organization
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Legal Business Name | KEITH A. COLLINS MD LLC
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 2017 METAIRIE RD
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City | METAIRIE
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State | LA
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Zip | 70005-3832
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Country | US
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Telephone | 504-832-8022
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Fax | 504-832-8044
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Provider Business Mailing Address
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Address Line | 2017 METAIRIE RD
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City | METAIRIE
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State | LA
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Zip | 70005-3832
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Country | US
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Telephone | 504-832-8022
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Fax | 504-832-8044
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KEITH ANDREW COLLINS
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Credential | MD
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Telephone | 504-832-8022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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