Individual
DR. PAUL CALVIN COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3875 E OVERLAND RD, MERIDIAN, ID 83642-9005
(208) 287-0203
(208) 288-5490
Mailing address
PO BOX 9515, BOISE, ID 83707-9515
(208) 287-0203
(208) 288-5490
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M4426
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002753900
—
ID
Enumeration date
11/10/2005
Last updated
07/13/2013
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