Provider Demographics
NPI:1669467411
Name:COLLINS, JONATHAN SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:SCOTT
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2489 IRON FORGE RD
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2917
Mailing Address - Country:US
Mailing Address - Phone:703-742-7472
Mailing Address - Fax:
Practice Address - Street 1:10810 CONNECTICUT AVE
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2138
Practice Address - Country:US
Practice Address - Phone:301-929-7161
Practice Address - Fax:301-929-7024
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2022-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101048905207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology