Provider Demographics
NPI:1003825324
Name:COLLISON, JOAN M T (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M T
Last Name:COLLISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIV OF KS MED CTR DEPT OF PSYCHIATRY - MAIL STOP 4015
Mailing Address - Street 2:3901 RAINBOW BLVD.
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-1300
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD # MS 4015
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-1300
Practice Address - Fax:913-588-1310
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-251862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry