Individual
ROGER L COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1420 OLD SQUARE RD, JACKSON, MS 39211
(601) 713-1145
(601) 713-1106
Mailing address
1420 OLD SQUARE RD, JACKSON, MS 39211
(601) 713-1145
(601) 713-1106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AC 8541636
MS
Other
Enumeration date
04/04/2007
Last updated
11/09/2010
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