| Mccollum Psychiatric Clinic | |
|
201 N 36th St Rogers AR 72756-1750 | |
| (479) 621-8600 | |
| Not Available |
| Full Name | Mccollum Psychiatric Clinic |
|---|---|
| Speciality | Psychologist |
| Location | 201 N 36th St, Rogers, Arkansas |
| Authorized Official Name and Position | William Mccollum (PRESIDENT) |
| Authorized Official Contact | 4796218600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mccollum Psychiatric Clinic 201 N 36th St Rogers AR 72756-1750 Ph: () - | Mccollum Psychiatric Clinic 201 N 36th St Rogers AR 72756-1750 Ph: (479) 621-8600 |
| NPI Number | 1992930903 |
|---|---|
| Provider Enumeration Date | 05/19/2009 |
| Last Update Date | 05/19/2009 |
| Medicare PECOS PAC ID | 7810048105 |
|---|---|
| Medicare Enrollment ID | O20090626000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992930903 | NPI | - | NPPES |
| 101217001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | C-6457 (Arkansas) | Primary |
| Provider Name | William E Mccollum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396815627 PECOS PAC ID: 7315996303 Enrollment ID: I20050117000559 |
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