Mccollum, Chad R

Mccollum, Chad R is an individual health care provider with primary practice located at 5605 W Eugie Ave Ste 110 , Glendale AZ 85304-1273. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Mccollum, Chad R can be contacted via phone (623) 847-2000.

Contact Information

Primary practice address
5605 W Eugie Ave Ste 110 Glendale AZ 85304-1273
Phone: (623) 847-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5259 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 5259 Arizona
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 5259 Arizona

Profile Details

NPI number 1659620672
LBN Legal business name Mccollum, Chad R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2012
Last updated Mar 11th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659620672 NPPES
Arizona MEDICAID 744737

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