Collins, Clark A

Collins, Clark A is an individual health care provider with primary practice located at 1504 Madison Ave , Fort Atkinson WI 53538-3100. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Collins, Clark A can be contacted via phone (920) 563-7888.

Contact Information

Primary practice address
1504 Madison Ave Fort Atkinson WI 53538-3100
Phone: (920) 563-7888
Fax: (920) 563-7741
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1029-023 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1029-023 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1029-023 Wisconsin

Profile Details

NPI number 1760449821
LBN Legal business name Collins, Clark A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Jun 21st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760449821 NPPES
Wisconsin Other 60272 DEAN HEALTH INSURANCE
Wisconsin MEDICAID 42974300 DEAN HEALTH INSURANCE

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