Collicott, Roger C
Collicott, Roger C is an sole proprietor health care provider with primary practice located at 100 Meadow Dr , Danville IN 46122-1414. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Collicott, Roger C can be contacted via phone (317) 718-0970.Contact Information
Primary practice address
100 Meadow Dr
Danville IN 46122-1414
Phone: (317) 718-0970
Fax: (317) 718-0973
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01033269A | Indiana |
Profile Details
| NPI number | 1346203411 |
|---|---|
| LBN Legal business name | Collicott, Roger C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 10th, 2006 |
| Last updated | Jun 16th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346203411 | NPPES |
| Indiana | MEDICAID | 100134020A |
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