MEDICARE: DR. LINDA F COLLINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	C5782	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346430980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA F COLLINS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 669
Second Line	:
City	:	MARIANNA
State	:	AR
Zip	:	72360-0669
Country	:	US
Telephone Number	:	870-295-5225
Fax Number	:	870-295-6900

Provider Business Practice Location Address
First Line	:	530 ATKINS BLVD
Second Line	:
City	:	MARIANNA
State	:	AR
Zip	:	72360-2113
Country	:	US
Telephone Number	:	870-295-5225
Fax Number	:	870-295-6900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	10/07/2008

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