Provider Demographics
NPI:1093000861
Name:COLLINS, ELISHA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELISHA
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELISHA
Other - Middle Name:M
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:101 E BRUNSON ST
Mailing Address - Street 2:STE 300
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2500
Mailing Address - Country:US
Mailing Address - Phone:334-393-3212
Mailing Address - Fax:334-393-4979
Practice Address - Street 1:101 E BRUNSON ST STE 300
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2500
Practice Address - Country:US
Practice Address - Phone:334-393-3212
Practice Address - Fax:614-656-3761
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.35360208600000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208600000XAllopathic & Osteopathic PhysiciansSurgery