Individual
JONATHAN C COLLINS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
206 CENTRE SOUTH BLVD, AIKEN, SC 29803-6319
(803) 642-9204
(803) 648-3633
Mailing address
30 CHERRY HILLS DR, AIKEN, SC 29803-5691
(803) 642-9525
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
11083
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110837
—
SC
Enumeration date
02/03/2006
Last updated
07/08/2007
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