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General NPI Number Information
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NPI Number | 1992984025
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Entity Type | Individual
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Provider Name | TIMOTHY JOHN MCCOLLUM PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 7261 S BROADWAY STE 103
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City | LITTLETON
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State | CO
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Zip | 80122-8018
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Country | US
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Telephone | 303-358-5130
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Fax | 720-510-2704
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Provider Business Mailing Address
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Address Line | 7261 S BROADWAY STE 103
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City | LITTLETON
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State | CO
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Zip | 80122-8018
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Country | US
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Telephone | 303-358-5130
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Fax | 720-510-2704
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1684
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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