Provider Demographics
NPI:1508868894
Name:COLLINS, MARY PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:PATRICIA
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1928 ALCOA HWY
Mailing Address - Street 2:STE 324
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1502
Mailing Address - Country:US
Mailing Address - Phone:865-524-9871
Mailing Address - Fax:865-305-6955
Practice Address - Street 1:2547 WILLOW POINT WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-3162
Practice Address - Country:US
Practice Address - Phone:865-244-2020
Practice Address - Fax:865-851-9352
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000019871207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
103I182003Medicare PIN
TNC03359Medicare UPIN