MEDICARE: DR. JAMIE LEE 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	MD.206815	LA

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	:	1518266493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE LEE COLLINS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2118
Second Line	:
City	:	OPELOUSAS
State	:	LA
Zip	:	70571-2118
Country	:	US
Telephone Number	:	337-662-4075
Fax Number	:

Provider Business Practice Location Address
First Line	:	1371 I-49 S SERVICE ROAD
Second Line	:
City	:	SUNSET
State	:	LA
Zip	:	70584-6134
Country	:	US
Telephone Number	:	337-678-4160
Fax Number	:	877-278-8499

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

Provider Enumeration Date	:	03/18/2011
Last Update Date	:	03/05/2020

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