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NPI 1821233750

NPI 1821233750 : WILLIAM M COLLINS : JENKINS, KY

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General NPI Number Information
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    NPI Number           |    1821233750
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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     |    12/05/2008
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    Last Update Date     |    06/02/2014
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Provider Practice Location Address
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    Address Line         |    157 DORTON-JENKINS HWY 
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    City                 |    JENKINS
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    State                |    KY
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    Zip                  |    41537
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    Country              |    US
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    Telephone            |    606-639-4020
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    Fax                  |    606-639-4021
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Provider Business Mailing Address
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    Address Line         |    157 DORTON JENKINS HWY 
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    City                 |    JENKINS
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    State                |    KY
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    Zip                  |    41537-8272
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    Country              |    US
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    Telephone            |    606-639-4020
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    Fax                  |    606-639-4021
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. WILLIAM MARTIN 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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    23375
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    License Number State |    KY
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