MEDICARE: COLLINS ANESTHESIA ASSOCIATES

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	207L00000X	Anesthesiology Physician

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	:	1952414161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLLINS ANESTHESIA ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 2585
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31902-2585
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 HIGHWAY 9 E
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-7833
Country	:	US
Telephone Number	:	843-390-8100
Fax Number	:

Authorized Official
Title or Position	:	BILLING CONTACT
Name	:	MARK MANNING III
Credential	:
Telephone Number	:	706-660-8505

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	08/22/2020

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Directions to “COLLINS ANESTHESIA ASSOCIATES ” Practice Location

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