Individual
COLLIS L BARKSDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
290 ENTERPRISE DR, EASLEY, SC 29642-8280
(864) 365-0290
Mailing address
290 ENTERPRISE DR, EASLEY, SC 29642-8280
(864) 365-0290
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20594
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205940
—
SC
Enumeration date
05/16/2006
Last updated
01/21/2015
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