MEDICARE: DR. SUZANNE CHAMBLEE COLLIER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD21976	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134119142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE CHAMBLEE COLLIER MD

Provider Business Mailing Address
First Line	:	PO BOX 1867
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-1867
Country	:	US
Telephone Number	:	931-455-2766
Fax Number	:	931-455-2829

Provider Business Practice Location Address
First Line	:	150 JACK FARRAR LN
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2398
Country	:	US
Telephone Number	:	931-455-2766
Fax Number	:	931-455-2829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/09/2020

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