MEDICARE: DR. LEONARD R 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	207V00000X	Obstetrics & Gynecology Physician	MD023015E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000144888	OTHER	PA	HIGHMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962499301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD R COLLINS M.D.

Provider Business Mailing Address
First Line	:	1201 GRAMPIAN BLVD
Second Line	:	SUITE 1K
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-1900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 HIGH ST
Second Line	:	SUITE 1004
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-3100
Country	:	US
Telephone Number	:	570-321-3300
Fax Number	:	570-321-3301

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	02/20/2015

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