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Organization
WATERTOWN INTERNISTS PC
Active
Organization
WATERTOWN INTERNISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLINS F KELLOGG JR. MD (PRESIDENT)
(315) 782-2141
Entity
Organization
Contact information
Practice address
53-59 PUBLIC SQUARE, SUITE 301, WATERTOWN, NY 13601
(315) 782-2141
(315) 782-5123
Mailing address
53-59 PUBLIC SQUARE, SUITE 301, WATERTOWN, NY 13601
(315) 782-2141
(315) 782-5123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01108621
—
NY
01
—
CN1323
RAILROAD MEDICARE
NY
Enumeration date
03/09/2006
Last updated
08/17/2018
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