Individual
JOHN O COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607
(919) 784-7093
(919) 784-7395
Mailing address
2510 E DUPONT RD, STE 201, FORT WAYNE, IN 46825-1601
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01070620A
IN
2084N0400X
Neurology Physician
Primary
2009-01357
NC
2084N0400X
Neurology Physician
35.127835
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060443
—
OH
05
—
201050780
—
IN
Enumeration date
07/27/2006
Last updated
08/07/2020
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