Provider Demographics
NPI:1033407333
Name:COLLINS, DOUGLAS P (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:P
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 AUBURN AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-585-3238
Mailing Address - Fax:513-585-3254
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-3238
Practice Address - Fax:513-585-3254
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-078719207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine