Doctor Name: | DR. JOHN RALPH COLLIP |
NPI Number: | 1710097571 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 01044478A |
Business Practice Address: | 415 W Main St Greenfield, IN - 461402056 |
Business Phone Number: | 3176791009 |
Business Fax Number: | 3178261370 |
Mailing Address: | 8268 Red Sail Ct, INDIANAPOLIS |
State: | IN |
Postal Code: | 462369574 |
Phone Number: | 3176791009 |
Fax Number: | 3178261370 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 08/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01044478A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |