Provider Demographics
NPI:1912193491
Name:FRANK R COLLIER JR M D P A
Entity Type:Organization
Organization Name:FRANK R COLLIER JR M D P A
Other - Org Name:COLLIER SPINE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:904-296-2229
Mailing Address - Street 1:6859 BELFORT OAKS PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6242
Mailing Address - Country:US
Mailing Address - Phone:904-296-2229
Mailing Address - Fax:904-296-3082
Practice Address - Street 1:6859 BELFORT OAKS PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6242
Practice Address - Country:US
Practice Address - Phone:904-296-2229
Practice Address - Fax:904-296-3082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL69991174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6489910001OtherMEDICARE DME PTAN
FLDB9960OtherRAILROAD MEDICARE
FL6489910001OtherMEDICARE DME PTAN