| John A. Collier,, D.d.s., P.a. | |
|
2162 S Lamar Blvd Oxford MS 38655-5224 | |
| (662) 236-1969 | |
| (662) 513-5878 |
| Full Name | John A. Collier,, D.d.s., P.a. |
|---|---|
| Speciality | Dentist |
| Location | 2162 S Lamar Blvd, Oxford, Mississippi |
| Authorized Official Name and Position | John Alex Collier (OWNER) |
| Authorized Official Contact | 6622361969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John A. Collier,, D.d.s., P.a. 2162 S Lamar Blvd Oxford MS 38655-5224 Ph: (662) 236-1969 | John A. Collier,, D.d.s., P.a. 2162 S Lamar Blvd Oxford MS 38655-5224 Ph: (662) 236-1969 |
| NPI Number | 1477825636 |
|---|---|
| Provider Enumeration Date | 02/03/2012 |
| Last Update Date | 02/03/2012 |
| Medicare PECOS PAC ID | 5092029314 |
|---|---|
| Medicare Enrollment ID | O20150730013471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477825636 | NPI | - | NPPES |
| 00660152 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2869-95 (Mississippi) | Primary |
| Provider Name | John Collier |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1376672618 PECOS PAC ID: 5890009617 Enrollment ID: I20150806011250 |
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