Individual
DR. COLLINS F KELLOGG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
53-59 PUBLIC SQ, STE 301, WATERTOWN, NY 13601-2674
(315) 782-2141
(315) 782-5123
Mailing address
53-59 PUBLIC SQ, STE 301, WATERTOWN, NY 13601-2674
(315) 782-2141
(315) 782-5123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
169537
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01074217
—
NY
01
—
2503552
GHI
NY
Enumeration date
05/23/2005
Last updated
10/25/2007
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