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NPI Code Detail

MEDICARE: MR. JOHN WILLIAM COLLINS M.D.

MEDICARE: MR. JOHN WILLIAM COLLINS M.D.
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
12084P0800XPsychiatry Physician046676GA
22084P0800XPsychiatry PhysicianMD176230OR

General Provider Information

NPI Number : 1609895341
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN WILLIAM COLLINS M.D.
Provider Business Mailing Address
First Line : 548 SE JACKSON ST
Second Line : ADAPT
City : ROSEBURG
State : OR
Zip : 97470-4983
Country : US
Telephone Number : 541-672-2691
Fax Number :
Provider Business Practice Location Address
First Line : 548 SE JACKSON ST
Second Line :
City : ROSEBURG
State : OR
Zip : 97470-4983
Country : US
Telephone Number : 541-672-2691
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 05/11/2016

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Directions to “ MR. JOHN WILLIAM COLLINS M.D.” Practice Location

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