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Organization
WM. WADE COLLISON MD
Active
Organization
WM. WADE COLLISON MD
Active
Other names
Prescott Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM WADE COLLISON M.D. (OWNER)
(928) 778-3838
Entity
Organization
Contact information
Practice address
1050 GAIL GARDNER WAY, SUITE 200, PRESCOTT, AZ 86305-1630
(928) 778-3838
(928) 778-5630
Mailing address
1050 GAIL GARDNER WAY, SUITE 200, PRESCOTT, AZ 86305-1630
(928) 778-3838
(928) 778-5630
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
10644
AZ
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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