Provider Demographics
NPI:1558675066
Name:COLLINS, H ROYER (MD)
Entity Type:Individual
Prefix:
First Name:H
Middle Name:ROYER
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 1:2122 E HIGHLAND AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4739
Mailing Address - Country:US
Mailing Address - Phone:602-553-3113
Mailing Address - Fax:602-667-7991
Practice Address - Street 1:2122 E HIGHLAND AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4739
Practice Address - Country:US
Practice Address - Phone:602-553-3113
Practice Address - Fax:602-667-7991
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16036207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
22259OtherAAOS
AZ3Z4870OtherHEALTHNET
AZ266206Medicaid
AZP00878645Medicare PIN
AZ20WCHWM03Medicare Oscar/Certification
AZZ140948Medicare PIN
AZ266206Medicaid