# J.R. COLLIP, M.D., LLC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** J.R. COLLIP, M.D., LLC.
- **Other names:** Morristown - Greenfield Family Medicine, Dr Collip
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1538440516
- **Legal business name:** J.R. COLLIP, M.D., LLC.
- **Authorized official:** JOHN RALPH COLLIP M.D. (M.D.)
- **Authorized official phone:** (765) 763-0212

## Contact information

- **Practice address:** 219 EAST MAIN STREET, MORRISTOWN, IN 46161-0438
- **Practice address phone:** (765) 763-0212
- **Practice address fax:** (765) 763-0210
- **Mailing address:** PO BOX 438, 219 EAST MAIN STREET, MORRISTOWN, IN 46161-0438
- **Mailing address phone:** (765) 763-0212
- **Mailing address fax:** (765) 763-0210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 01044478A | IN | Yes |

## Other

- **Enumeration date:** 09/02/2011
- **Last updated:** 09/02/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2000725208 | — | IN |