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General NPI Number Information
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NPI Number | 1417121849
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Entity Type | Individual
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Provider Name | A COLLINS VILLAMOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 2635 N DYSART RD
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City | AVONDALE
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State | AZ
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Zip | 85392-2001
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Country | US
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Telephone | 623-237-3440
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Fax | 480-685-8379
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Provider Business Mailing Address
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Address Line | 2416 W ESPARTERO WAY
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City | PHOENIX
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State | AZ
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Zip | 85086-5525
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Country | US
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Telephone | 623-237-3440
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Fax | 480-685-8379
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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 | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 47017
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License Number State | AZ
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