Provider Demographics
NPI:1528374204
Name:EUGENE COLLINS MDPC
Entity Type:Organization
Organization Name:EUGENE COLLINS MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-322-6666
Mailing Address - Street 1:1333 WEST LOMBARD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-2194
Mailing Address - Country:US
Mailing Address - Phone:563-322-6666
Mailing Address - Fax:563-322-6844
Practice Address - Street 1:1333 WEST LOMBARD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-2194
Practice Address - Country:US
Practice Address - Phone:563-322-6666
Practice Address - Fax:563-322-6844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21720207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty