Ellis Morgan Collins Jr., M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

C-2851 Issued in AR

Practice address

1301 E Broadway St
Forrest City, AR 72335-3922

Phone

(870) 633-5761

Fax

(870) 633-5761

NPI assigned

Dec 10, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1962647628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E BROADWAY ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723353922",
            "telephone_number": "870-633-5761",
            "fax_number": "870-633-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E BROADWAY ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723353922",
            "telephone_number": "870-633-5761",
            "fax_number": "870-633-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ELLIS",
        "middle_name": "MORGAN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AR",
            "license": "C-2851",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AR",
            "license": "C-2851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Knosurer Cochran, MHPP
• Melissa Trenice Cochran, PHARMD
• Francis Dale Coleman, MHP
• Catherine Coleman, LPC
• Bessie Collins
• George Conner III, MD
• Amy Cook, RN
• Schelly Corley, RN
• Liza Jovellano Cornelio, P.T.
• David M Coss, M.D.

• General Practice Physician in Forrest City, AR
• Providers in Forrest City, AR by specialty
• General Practice Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.