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General NPI Number Information
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NPI Number | 1851402572
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Entity Type | Individual
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Provider Name | WILLIAM T COLLINS JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 4037 TAYLOR RD SUITE A
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5535
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Country | US
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Telephone | 757-483-1403
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Fax | 757-483-3757
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Provider Business Mailing Address
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Address Line | 4037 TAYLOR RD SUITE A
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5535
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Country | US
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Telephone | 757-483-1403
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Fax | 757-483-3757
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4834367-8905
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101034439
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License Number State | VA
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