MEDICARE: DR. ROBERT HENRY COLLINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35048117	OH
2	2086S0129X	Vascular Surgery Physician	35-048117	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	020034064	OTHER	OH	RAILLROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	743190	OTHER	OH	BUCKEYE
2	0643412	OTHER	OH	AETNA
3	000000021293	OTHER	OH	ANTHEM
5	297849	OTHER	OH	AMERIGROUP

General Provider Information

NPI Number	:	1083691521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT HENRY COLLINS M.D.

Provider Business Mailing Address
First Line	:	1270 SOLUTIONS CENTER
Second Line	:	PO BOX 771270
City	:	CHICAGO
State	:	IL
Zip	:	60677-1002
Country	:	US
Telephone Number	:	513-542-6898
Fax Number	:	513-542-7972

Provider Business Practice Location Address
First Line	:	10506 MONTGOMERY ROAD
Second Line	:	STE. 101
City	:	CINCINNATI
State	:	OH
Zip	:	45242-4400
Country	:	US
Telephone Number	:	513-794-1601
Fax Number	:	513-794-1620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	11/22/2011

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Directions to “ DR. ROBERT HENRY COLLINS M.D.” Practice Location

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