Provider Demographics
NPI:1568879575
Name:DORWYN C COLLIER, P.C.
Entity Type:Organization
Organization Name:DORWYN C COLLIER, P.C.
Other - Org Name:WINDSOR WORKCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DORWYN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:574-266-6555
Mailing Address - Street 1:3100 WINDSOR CT
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-5556
Mailing Address - Country:US
Mailing Address - Phone:574-266-6555
Mailing Address - Fax:574-266-6888
Practice Address - Street 1:410 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:IN
Practice Address - Zip Code:46540-9216
Practice Address - Country:US
Practice Address - Phone:574-825-3400
Practice Address - Fax:574-825-3424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02001521A261QU0200X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine