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Organization
NGA COLLARD PSC
Active
Organization
NGA COLLARD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NGA COLLARD MD (PHYSICIANOWNER)
(270) 765-7676
Entity
Organization
Contact information
Practice address
1239 WOODLAND DR, SUITE 105, ELIZABETHTOWN, KY 42701-2770
(270) 765-7676
(270) 982-9222
Mailing address
1239 WOODLAND DR, SUITE 105, ELIZABETHTOWN, KY 42701-2770
(270) 765-7676
(270) 765-3015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23094
KY
Other
Enumeration date
08/20/2006
Last updated
08/20/2007
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