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General NPI Number Information
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NPI Number | 1992930903
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Entity Type | Organization
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Legal Business Name | WILLIAM E. MCCOLLUM, M.D., P.A.
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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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 |
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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 |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM MCCOLLUM
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Credential | M.D.
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Telephone | 479-621-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | C-6457
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License Number State | AR
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