Healthcare Provider Details

I. General information

NPI: 1740275338
Provider Name (Legal Business Name): ANDREW K COLLINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 E ARBOR AVE STE 101
MESA AZ
85206-6102
US

IV. Provider business mailing address

3260 N HAYDEN RD STE 112
SCOTTSDALE AZ
85251-6650
US

V. Phone/Fax

Practice location:
  • Phone: 480-985-1700
  • Fax: 480-396-3659
Mailing address:
  • Phone: 602-264-9100
  • Fax: 602-264-9101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number23261
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: