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Organization

RICHARD D. COLLISON, M.D.,P.C.

Active
Parent organization
RICHARD COLLISON MD PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
RICHARD COLLISON MD PC
Authorized official
DR. RICHARD DAVIS COLLISON M.D. (PRESIDENT)
(928) 778-5443
Entity
Organization

Contact information

Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1641
(928) 778-5443
(928) 443-1572
Mailing address
PO BOX 2860, PRESCOTT, AZ 86302-2860
(928) 778-5443
(928) 443-1572

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
15632
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1669448395
INDIVIDUAL NPI NEED GRP
AZ
05
249559
AZ
Enumeration date
06/25/2007
Last updated
09/13/2011
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