Individual
MR. DEREK COLLINS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
145 JOHNSON AVE, FAYETTEVILLE, GA 30214-2079
(912) 283-5260
Mailing address
101 ASHLEY PARK DR APT F304, NEWNAN, GA 30263-3255
(954) 864-0908
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GAA-NP001489
GA
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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