Provider Demographics
NPI:1790713329
Name:HOLLINS, LORI-LINELL COLBY (MD)
Entity Type:Individual
Prefix:
First Name:LORI-LINELL
Middle Name:COLBY
Last Name:HOLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LORI-LINELL
Other - Middle Name:HOLLINS
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8149 POINT MEADOWS WAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9111
Mailing Address - Country:US
Mailing Address - Phone:904-260-0352
Mailing Address - Fax:904-363-9818
Practice Address - Street 1:8149 POINT MEADOWS WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9111
Practice Address - Country:US
Practice Address - Phone:904-260-0352
Practice Address - Fax:904-363-9818
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-054713207VE0102X
FLME133900207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0994965Medicaid
D34030Medicare UPIN
OH0994965Medicaid