Individual
WILLIAM C COLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11108 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1730
(260) 266-5700
(260) 266-5920
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01038500A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641069
ANTHEM
IN
05
—
0134296
—
OH
01
—
060070582
RR MEDICARE
IN
05
—
100102400
—
IN
01
—
P00782360
R.R. MEDICARE
IN
Enumeration date
08/11/2005
Last updated
10/10/2022
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