Healthcare Provider Details

I. General information

NPI: 1811974249
Provider Name (Legal Business Name): WILLIAM JOSEPH COLLINS III D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 33100 BOX LANDSTUHL
APO AE
09180-3100
US

IV. Provider business mailing address

200 CHEROKEE CT
NEWPORT NEWS VA
23608-2705
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-7383
  • Fax:
Mailing address:
  • Phone: 757-874-3202
  • Fax: 757-314-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0103000689
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0103000689
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: