Provider Demographics
NPI:1588764369
Name:COLLINS, JOHN JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JEFFREY
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:131 MADISON AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7360
Mailing Address - Country:US
Mailing Address - Phone:973-326-9000
Mailing Address - Fax:973-326-9001
Practice Address - Street 1:131 MADISON AVE FL 3
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7360
Practice Address - Country:US
Practice Address - Phone:973-326-9000
Practice Address - Fax:973-326-9001
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10843400207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0736597Medicaid
WV1808037000Medicaid
WVCO4074361Medicare ID - Type Unspecified