MEDICARE: DR. MARK S. 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
1	207RH0003X	Hematology & Oncology Physician	35065485	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1962451021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK S. COLLINS M.D.

Provider Business Mailing Address
First Line	:	1492 E BROAD ST
Second Line	:	TOWER 13
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1546
Country	:	US
Telephone Number	:	614-257-2900
Fax Number	:	614-257-2079

Provider Business Practice Location Address
First Line	:	1492 E BROAD ST
Second Line	:	TOWER 13
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1546
Country	:	US
Telephone Number	:	614-257-2900
Fax Number	:	614-257-2079

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	01/10/2014

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