Provider Demographics
NPI:1972502847
Name:COLLINS, BARRY J (DO)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:J
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:61 W CARLETON RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-1201
Mailing Address - Country:US
Mailing Address - Phone:517-439-5411
Mailing Address - Fax:517-439-5418
Practice Address - Street 1:61 W CARLETON RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-1201
Practice Address - Country:US
Practice Address - Phone:517-439-5411
Practice Address - Fax:517-439-5418
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBC012672207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1018675OtherWELLNESS PLAN
MIBC012672OtherMICHIG
MIP00048258OtherRRMCR
MI300007749OtherPPOM
MI200000004017OtherPHP
MI9021OtherHPOM
MI100570OtherGLPH
MI4371080Medicaid
MIH13349Medicare UPIN
MI9021OtherHPOM