Individual
DR. R. DOUGLAS MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2101 47TH ST, MOLINE, IL 61265-3663
(309) 762-3931
(309) 762-4938
Mailing address
2101 47TH ST, MOLINE, IL 61265-3663
(309) 762-3931
(309) 762-4938
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
00213
IA
103T00000X
Psychologist
Primary
—
IL
103TC2200X
Clinical Child & Adolescent Psychologist
00512
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58957
WELLMARK BCBS
IA
Enumeration date
03/05/2007
Last updated
09/25/2007
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