Provider Demographics
NPI:1811105331
Name:COLLINS, JAMES J (MD, PHD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:525 BRANSON LANDING BLVD STE 501
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2125
Practice Address - Country:US
Practice Address - Phone:417-269-1010
Practice Address - Fax:417-269-6755
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20120317722084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1811105331Medicaid
MOP01128071OtherRR MCR
OK200485940 AMedicaid
MO431560263OtherTRICARE
AR195707001Medicaid
MO431560263OtherTRICARE