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Individual

MR. JOHN ERNEST COLLINS I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
(505) 256-5417
Mailing address
2315 CHERRY TREE LN SW, ALBUQUERQUE, NM 87105-7062
(505) 452-0267

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2004-0008
NM

Other

Enumeration date
10/10/2006
Last updated
07/08/2007
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