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NPI Code Detail

MEDICARE: DR. RICHARD B COLLINS DO

MEDICARE: DR. RICHARD B COLLINS DO
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
12085R0202XDiagnostic Radiology Physician02002685AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447250188
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD B COLLINS DO
Provider Business Mailing Address
First Line : PO BOX 80070
Second Line :
City : FORT WAYNE
State : IN
Zip : 46898-0070
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Provider Business Practice Location Address
First Line : 5001 US HIGHWAY 30 W STE D
Second Line :
City : FORT WAYNE
State : IN
Zip : 46818-9701
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 11/13/2014

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Directions to “ DR. RICHARD B COLLINS DO” Practice Location

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