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Individual

PHILLIP B COLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
127 MASCOMA ST, LEBANON, NH 03766-2661
(603) 448-7459
(603) 448-7469
Mailing address
10 ALICE PECK DAY DR, LEBANON, NH 03766-2694
(603) 448-3121
(603) 448-7462

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
10496
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00039897
BLUE CROSS BLUE SHIELD VT
VT
05
1008021
VT
01
1518946771
MVP
NH
05
30200260
NH
01
COLL251643
ANTHEM NH
NH
Enumeration date
01/16/2006
Last updated
05/05/2017
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