Organization
MCMD, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOHN COLLINS MD (SOLE PROPRIETORSHIP)
(270) 782-6362
Entity
Organization
Contact information
Practice address
1340 ELLIS PLACE, BOWLING GREEN, KY 42104
(270) 782-6362
(270) 796-2800
Mailing address
1340 ELLIS PLACE, BOWLING GREEN, KY 42104
(270) 782-6362
(270) 796-2800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19109
KY
207Q00000X
Family Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
641910
—
KY
Enumeration date
04/20/2007
Last updated
06/16/2015
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