Provider Demographics
NPI:1275198129
Name:KAVURI & COLLIER INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:KAVURI & COLLIER INTERNAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:FARRIS
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-697-9097
Mailing Address - Street 1:220 BROAD MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2481
Mailing Address - Country:US
Mailing Address - Phone:478-697-9097
Mailing Address - Fax:478-275-2322
Practice Address - Street 1:227 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2969
Practice Address - Country:US
Practice Address - Phone:478-272-1366
Practice Address - Fax:478-275-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty