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Individual
DR. ALFONZA MCCOLLUM JR.
Active
Individual
DR. ALFONZA MCCOLLUM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME83401
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407844558
TRICARE
FL
05
—
267116600
—
FL
01
—
57851
BCBS
FL
01
—
P00444511
RAILROAD MEDICARE NUMBER
FL
Enumeration date
10/12/2005
Last updated
11/30/2015
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