MEDICARE: RYAN COLLINS PA

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
1	363A00000X	Physician Assistant	2436	AL

General Provider Information

NPI Number	:	1023679214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN COLLINS PA

Provider Business Mailing Address
First Line	:	PO BOX 55310
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35255-5310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 INTERNATIONAL PARK DR STE 140
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-4217
Country	:	US
Telephone Number	:	615-997-9107
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2019
Last Update Date	:	05/21/2025

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Directions to “ RYAN COLLINS PA” Practice Location

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