Collins, Mark Jerome

Collins, Mark Jerome is an individual health care provider with primary practice located at 5940 E Copper Hill Dr Suite B, Prescott Valley AZ 86314-2860. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Collins, Mark Jerome can be contacted via phone (702) 379-2227.

Contact Information

Primary practice address
5940 E Copper Hill Dr Suite B Prescott Valley AZ 86314-2860
Phone: (702) 379-2227
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 4145 Arizona
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 766 Nevada
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 02847 Iowa
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 20A12037 California

Profile Details

NPI number 1295747368
LBN Legal business name Collins, Mark Jerome
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated May 25th, 2016 - about 9 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 1295747368 NPPES
California Other W-416 MEDICARE PTAN
California MEDICAID 002019797 MEDICARE PTAN

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