Healthcare Provider Details

I. General information

NPI: 1679890255
Provider Name (Legal Business Name): KRISTOPHER D COLLINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2010
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2656 N COLUMBUS ST STE D
LANCASTER OH
43130-8991
US

IV. Provider business mailing address

2656 N COLUMBUS ST STE D
LANCASTER OH
43130-8991
US

V. Phone/Fax

Practice location:
  • Phone: 406-873-3467
  • Fax: 740-689-9736
Mailing address:
  • Phone: 740-687-3346
  • Fax: 740-689-9736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101260706
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number35.145816
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35.145816
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: