Mccollum, Alfonza

Mccollum, Alfonza is an individual health care provider with primary practice located at 461 South Nova Road , Ormond Beach FL 33174-6138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mccollum, Alfonza can be contacted via phone (386) 671-4337.

Contact Information

Primary practice address
461 South Nova Road Ormond Beach FL 33174-6138
Phone: (386) 671-4337
Fax: (386) 671-7242
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME83401 Florida

Profile Details

NPI number 1407844558
LBN Legal business name Mccollum, Alfonza
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Nov 30th, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407844558 NPPES
Florida Other 1407844558 TRICARE
Florida MEDICAID 267116600 TRICARE
Florida Other P00444511 TRICARE
Florida Other 57851 TRICARE

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