Individual
DR. EARLE SMITH COLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10401 W THUNDERBIRD BLVD, SUN CITY, AZ 85351-3004
(623) 977-7721
Mailing address
PO BOX 27340, PHOENIX, AZ 85061-7340
(602) 943-9200
(602) 216-3000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
17037
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111295
—
AZ
01
—
1Z7112
HEALTH NET AZ-SUN CITY PA
AZ
01
—
AX4478
HEALTH NET AZ-PATH ASSOC
AZ
01
—
AZ0182900
BCBSAZ-PATH ASSOC
AZ
01
—
AZ0828790
BCBSAZ-SUN CITY PATH
AZ
Enumeration date
03/27/2006
Last updated
11/30/2007
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