Provider Demographics
NPI:1922286277
Name:COLLINS, EDGAR E (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:E
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDGAR
Other - Middle Name:E
Other - Last Name:COLLINS
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3466 N 2575 W
Mailing Address - Street 2:
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404-8611
Mailing Address - Country:US
Mailing Address - Phone:801-731-6577
Mailing Address - Fax:801-731-8089
Practice Address - Street 1:747 E SAINT GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3035
Practice Address - Country:US
Practice Address - Phone:435-673-6111
Practice Address - Fax:435-673-1510
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT134387-12052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry