Udall, Collin
Udall, Collin is an individual health care provider with primary practice located at 3048 E Baseline Rd Ste 109, Mesa AZ 85204-7287. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Udall, Collin can be contacted via phone (480) 632-1117.Contact Information
Primary practice address
3048 E Baseline Rd Ste 109
Mesa AZ 85204-7287
Phone: (480) 632-1117
Fax: (480) 632-1118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 15439 | Arizona |
Profile Details
| NPI number | 1861495434 |
|---|---|
| LBN Legal business name | Udall, Collin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2005 |
| Last updated | Sep 13th, 2011 - about 15 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 | 1861495434 | NPPES |
| Arizona | Other | AZ0878720 | BLUE CROSS BLUE SHIELD |
| Arizona | Other | 1Z1014 | BLUE CROSS BLUE SHIELD |
| Arizona | Other | 621104 | BLUE CROSS BLUE SHIELD |
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