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1083486542
DEREK COLLINS
FAYETTEVILLE, GA
NPI
1083486542
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: GA GAA-NP001489)
Enumeration Date
2023-10-26
Last Update Date
2023-10-26
Business Address
Mr. DEREK COLLINS NP
145 JOHNSON AVE
FAYETTEVILLE, GA 30214-2079
Phone number: 912-283-5260
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Mailing Address
Mr. DEREK COLLINS NP
101 ASHLEY PARK DR APT F304
NEWNAN, GA 30263-3255
Phone number: 954-864-0908
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