Individual
DR. JOHN EDWIN MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 E WHISKEY RUN RD NE, NEW SALISBURY, IN 47161-9345
(812) 738-4251
Mailing address
PO BOX 38, CORYDON, IN 47112-0038
(812) 738-4251
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01032427
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042492
BLUE SHEILD
—
05
—
100128370A
—
IN
Enumeration date
07/08/2005
Last updated
12/29/2020
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