Individual
MR. DARRELL BERNARD COLLIERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CFA PA
Contact information
Practice address
15200 COMMUNITY RD, GULFPORT, MS 39523
(228) 575-7000
Mailing address
230 AUDUBON DRIVE, MANDEVILLE, LA 70471
(985) 845-1501
(985) 845-1601
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
616147
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
616147
NATL 1ST ASSIST CORP
—
Enumeration date
07/24/2008
Last updated
07/24/2008
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