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Individual

SUSAN A MCCOLLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
800 MEDICAL CENTER DR, FAIRMONT, MN 56031-4575
(507) 238-4263
Mailing address
5742 102ND ST, ARMSTRONG, IA 50514-7413
(712) 864-3911

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
44540
MN
207R00000X
Internal Medicine Physician
35-071114
OH
207R00000X
Internal Medicine Physician
4477
SD

Other

Enumeration date
03/28/2013
Last updated
03/28/2013
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