Provider Demographics
NPI:1407147176
Name:COLLIS, PHILIP N (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:N
Last Name:COLLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610B HUME ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2241
Mailing Address - Country:US
Mailing Address - Phone:614-271-0141
Mailing Address - Fax:
Practice Address - Street 1:302 OLD LEBANON DIRT RD STE 200
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2391
Practice Address - Country:US
Practice Address - Phone:615-391-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY47738207XX0005X
TN64869207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine