Provider Demographics
NPI:1942299482
Name:COLLINS, VERA (MD)
Entity Type:Individual
Prefix:DR
First Name:VERA
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 WE KNIGHT DR
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-6248
Mailing Address - Country:US
Mailing Address - Phone:479-709-8686
Mailing Address - Fax:479-709-8687
Practice Address - Street 1:3500 WE KNIGHT DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-6248
Practice Address - Country:US
Practice Address - Phone:479-709-8686
Practice Address - Fax:479-709-8687
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA860392132AMedicaid
GAH86605Medicare UPIN
GA860392132AMedicaid