| Mcmd, Psc | |
|
1340 Ellis Place Bowling Green KY 42104 | |
| (270) 782-6362 | |
| (270) 796-2800 |
| Full Name | Mcmd, Psc |
|---|---|
| Speciality | Family Medicine |
| Location | 1340 Ellis Place, Bowling Green, Kentucky |
| Authorized Official Name and Position | Michael John Collins (SOLE PROPRIETORSHIP) |
| Authorized Official Contact | 2707826362 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcmd, Psc 1340 Ellis Place Bowling Green KY 42104 Ph: (270) 782-6362 | Mcmd, Psc 1340 Ellis Place Bowling Green KY 42104 Ph: (270) 782-6362 |
| NPI Number | 1740407667 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 06/16/2015 |
| Medicare PECOS PAC ID | 9830294768 |
|---|---|
| Medicare Enrollment ID | O20070420000285 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740407667 | NPI | - | NPPES |
| 641910 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | 19109 (Kentucky) | Primary |
| Provider Name | Michael J Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558333286 PECOS PAC ID: 7214032143 Enrollment ID: I20070420000271 |
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