Provider Demographics
NPI:1194810176
Name:COLLINS, GERALD J (DC)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:J
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 BESSEMER SUPER HWY
Mailing Address - Street 2:
Mailing Address - City:MIDFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35228-3002
Mailing Address - Country:US
Mailing Address - Phone:205-923-0151
Mailing Address - Fax:205-923-3013
Practice Address - Street 1:552 BESSEMER SUPER HWY
Practice Address - Street 2:
Practice Address - City:MIDFIELD
Practice Address - State:AL
Practice Address - Zip Code:35228-3002
Practice Address - Country:US
Practice Address - Phone:205-923-0151
Practice Address - Fax:205-923-3013
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1208111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-71234OtherBLUE CROSS
ALI833Medicare ID - Type Unspecified
ALUO2661Medicare UPIN