Provider Demographics
NPI:1255314118
Name:COLLINS, JOHN RONALD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RONALD
Last Name:COLLINS
Suffix:JR
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 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN550802085R0202X
NC004172085R0202X
AL179042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL136790Medicaid
AL140793Medicaid
AL140886Medicaid
AL141123Medicaid
TN240519Medicaid
AL247104Medicaid
AL009942876Medicaid
AL246338Medicaid
AL009910981Medicaid
AL246236Medicaid
AL263023Medicaid
AL212200Medicaid
AL263011Medicaid
AL5166872OtherBCBS
AL127007Medicaid
AL246237Medicaid
AL24652Medicaid
AL247801Medicaid
AL51595597OtherBCBS
AL51595611OtherBCBS
AL246129Medicaid
AL51595607OtherBCBS
AL51595604OtherBCBS
AL51595610OtherBCBS
11704219OtherCAQH
AL141131Medicaid
AL51595609OtherBCBS