Provider Demographics
NPI:1043826803
Name:COLLINS, RICK D III (IP)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:D
Last Name:COLLINS
Suffix:III
Gender:M
Credentials:IP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 JASPER RD
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-7832
Mailing Address - Country:US
Mailing Address - Phone:937-520-1362
Mailing Address - Fax:
Practice Address - Street 1:997 JASPER RD
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-7832
Practice Address - Country:US
Practice Address - Phone:937-520-1362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health