Provider Demographics
NPI:1396075396
Name:COLLINS, JAMES H (CST/CFA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
Last Name:COLLINS
Suffix:
Gender:M
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 HOLMAR DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-9550
Mailing Address - Country:US
Mailing Address - Phone:601-214-2373
Mailing Address - Fax:
Practice Address - Street 1:150 HOLMAR DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-9550
Practice Address - Country:US
Practice Address - Phone:601-214-2373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant