Provider Demographics
NPI:1457596157
Name:KEITH A. COLLINS MD LLC
Entity Type:Organization
Organization Name:KEITH A. COLLINS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-832-8022
Mailing Address - Street 1:2017 METAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3832
Mailing Address - Country:US
Mailing Address - Phone:504-832-8022
Mailing Address - Fax:504-832-8044
Practice Address - Street 1:2017 METAIRIE RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3832
Practice Address - Country:US
Practice Address - Phone:504-832-8022
Practice Address - Fax:504-832-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty