Individual
DR. JOHN W. COLLINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19550 E 39TH ST S, SUITE 400, INDEPENDENCE, MO 64057-2303
(816) 254-4800
(816) 254-4641
Mailing address
3709 S BOLGER CT, INDEPENDENCE, MO 64055-3971
(816) 254-4800
(816) 254-4641
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R3688
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200255602
—
MO
Enumeration date
08/23/2005
Last updated
02/10/2019
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