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General NPI Number Information
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NPI Number | 1477693380
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Entity Type | Organization
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Legal Business Name | WILLIAM M COLLINS
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 109 E MAIN ST
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City | WHITESBURG
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State | KY
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Zip | 41858-7351
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Country | US
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Telephone | 606-633-4488
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Fax | 606-633-8383
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Provider Business Mailing Address
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Address Line | 109 E MAIN ST
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City | WHITESBURG
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State | KY
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Zip | 41858-7351
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Country | US
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Telephone | 606-633-4488
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Fax | 606-633-8383
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Authorized Official
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Title or Position | OWNER
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Name | WILLAIM M COLLINS
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Credential | MD
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Telephone | 606-633-4488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 23375
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License Number State | KY
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