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NPI Code Detail

MEDICARE: SHANNON E COLLINS MD

MEDICARE: SHANNON E COLLINS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program35300FL
2207R00000XInternal Medicine Physician76353AZ

General Provider Information

NPI Number : 1003554676
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON E COLLINS MD
Provider Business Mailing Address
First Line : 5055 E BROADWAY BLVD STE A100
Second Line :
City : TUCSON
State : AZ
Zip : 85711-3629
Country : US
Telephone Number : 520-327-0460
Fax Number :
Provider Business Practice Location Address
First Line : 2055 W HOSPITAL DR STE 255
Second Line :
City : TUCSON
State : AZ
Zip : 85704-7857
Country : US
Telephone Number : 205-547-5725
Fax Number : 520-547-5735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2022
Last Update Date : 07/09/2025

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Directions to “ SHANNON E COLLINS MD” Practice Location

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