Provider Demographics
NPI:1437203833
Name:COLLINS, RONALD KEVIN (DC DR CHIROPRACTIC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:KEVIN
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DC DR CHIROPRACTIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 GENERAL DEGAULLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114
Mailing Address - Country:US
Mailing Address - Phone:504-362-6000
Mailing Address - Fax:504-362-6010
Practice Address - Street 1:3906 GENERAL DEGAULLE DRIVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114
Practice Address - Country:US
Practice Address - Phone:504-362-6000
Practice Address - Fax:504-362-6010
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA683111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1939790Medicaid
2029AOtherBLUE CROSS BLUE SHIELD
U34291Medicare UPIN
59134Medicare ID - Type Unspecified