Provider Demographics
NPI:1215958020
Name:COLLINS, JAMES E (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:420 E 2ND AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3210
Mailing Address - Country:US
Mailing Address - Phone:706-509-3000
Mailing Address - Fax:706-292-7600
Practice Address - Street 1:330 TURNER MCCALL BLVD SW
Practice Address - Street 2:SUITE 101
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-5630
Practice Address - Country:US
Practice Address - Phone:706-291-2745
Practice Address - Fax:706-291-6759
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA029833207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00365703DMedicaid
GA00365703DMedicaid
GA08BDMKXMedicare PIN