Provider Demographics
NPI:1821312836
Name:COLLINS, ELIZABETH CLAY (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CLAY
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2118
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70571-2118
Mailing Address - Country:US
Mailing Address - Phone:337-662-4075
Mailing Address - Fax:337-662-4074
Practice Address - Street 1:1371 I-49 S SERVICE ROAD
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:LA
Practice Address - Zip Code:70584-6134
Practice Address - Country:US
Practice Address - Phone:337-678-4160
Practice Address - Fax:877-278-8499
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA206041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine