# SAMUEL L COLLINS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1225107089
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | PA00601 | OR | — |
| 363AS0400X | Surgical Physician Assistant | PA60475541 | WA | — |
| 363AS0400X | Surgical Physician Assistant | PA9103177 | FL | — |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 08/23/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2037524 | — | WA |
| 05 | — | 292272000 | — | FL |