Provider Demographics
NPI:1548405244
Name:COLLIER, CAITLIN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ELIZABETH
Last Name:COLLIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2257 W ELM ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WRIGHTSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31096-2056
Mailing Address - Country:US
Mailing Address - Phone:478-864-0032
Mailing Address - Fax:478-864-1220
Practice Address - Street 1:501 SPARTA RD
Practice Address - Street 2:SUITE F
Practice Address - City:SANDERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31082-1371
Practice Address - Country:US
Practice Address - Phone:478-552-0001
Practice Address - Fax:478-552-9016
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA074737207Q00000X
SCLL34651207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003167018AMedicaid
GA003167018BMedicaid
GA003167018AMedicaid