Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 01070620A | IN |
Y | 2084N0400X | Neurologist | 2009-01357 | NC |
N | 2084N0400X | Neurologist | 35.127835 | OH |
NPI | 1003830399 |
---|---|
Provider Name | John O Collins |
First Address | Fort Wayne, IN 46825-1601 |
Second Address | Raleigh, NC 27607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 07/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0060443 | (05) | OH |
201050780 | (05) | IN |
G55211 | (02) | WV |