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NPI 1396815627

NPI 1396815627 : WILLIAM E MCCOLLUM M.D. : ROGERS, AR

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General NPI Number Information
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    NPI Number           |    1396815627
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM E MCCOLLUM M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/08/2006
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    Last Update Date     |    07/16/2013
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Provider Practice Location Address
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    Address Line         |    201 N 36TH ST 
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    City                 |    ROGERS
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    State                |    AR
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    Zip                  |    72756-1750
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    Country              |    US
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    Telephone            |    479-621-8600
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    Fax                  |    479-621-8661
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Provider Business Mailing Address
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    Address Line         |    201 N 36TH ST 
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    City                 |    ROGERS
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    State                |    AR
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    Zip                  |    72756-1750
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    Country              |    US
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    Telephone            |    479-621-8600
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    Fax                  |    479-621-8661
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    C6457
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    License Number State |    AR
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