Organization
WM. WADE COLLISON MD
Active
Other names
Prescott Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM WADE COLLISON M.D. (OWNER)
(928) 778-3838
Entity
Organization
Contact information
Practice address
1050 GAIL GARDNER WAY, SUITE 200, PRESCOTT, AZ 86305-1630
(928) 778-3838
(928) 778-5630
Mailing address
1050 GAIL GARDNER WAY, SUITE 200, PRESCOTT, AZ 86305-1630
(928) 778-3838
(928) 778-5630
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
10644
AZ
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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