Provider Demographics
NPI:1760472708
Name:COLLINS, RONALD L (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
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:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0116
Mailing Address - Country:US
Mailing Address - Phone:256-533-7064
Mailing Address - Fax:256-704-0115
Practice Address - Street 1:201 GOVERNORS DR SW STE 400
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5183
Practice Address - Country:US
Practice Address - Phone:256-265-7246
Practice Address - Fax:256-265-7017
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00014728208VP0014X
ALMD.14728207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000036597Medicaid
E33536Medicare UPIN
AL000036597Medicaid