Provider Demographics
NPI:1336726892
Name:COLLINS, ARMIKA (DO)
Entity type:Individual
Prefix:
First Name:ARMIKA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ARMIKA
Other - Middle Name:
Other - Last Name:TATUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:725 UNIVERSITY BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45324-2640
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 UNIVERSITY BLVD FL 3
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45324-2640
Practice Address - Country:US
Practice Address - Phone:937-245-7817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHFC4786197207Q00000X, 207QA0401X
OHAM2789482390200000X, 390200000X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine