Provider Demographics
NPI:1518952597
Name:COLLIER, ROBERT CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CRAIG
Last Name:COLLIER
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 1:1100 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-2336
Mailing Address - Country:US
Mailing Address - Phone:931-393-2020
Mailing Address - Fax:931-455-6501
Practice Address - Street 1:1100 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2336
Practice Address - Country:US
Practice Address - Phone:931-393-2020
Practice Address - Fax:931-455-6501
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21605207W00000X
TNMD21605207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN180021876OtherRAILROAD MEDICARE
TN3062535Medicaid
TNP00465135OtherRAILROAD MEDICARE
TNE94544Medicare UPIN
TN180021876OtherRAILROAD MEDICARE
TN3062535Medicaid