Provider Demographics
NPI:1194734095
Name:COLLISON, JAMES S (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:COLLISON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 WESTHILL DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4705
Mailing Address - Country:US
Mailing Address - Phone:715-847-2020
Mailing Address - Fax:715-847-0020
Practice Address - Street 1:3200 WESTHILL DR
Practice Address - Street 2:SUITE 210
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4705
Practice Address - Country:US
Practice Address - Phone:715-847-2020
Practice Address - Fax:715-847-0020
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI341182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32665300Medicaid
WIF55861Medicare UPIN