MEDICARE: SUZANNE C. COLLIER

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	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1215125869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUZANNE C. COLLIER

Provider Business Mailing 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

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	:	OWNDER
Name	:	SUZANNE COLLIER
Credential	:	MD
Telephone Number	:	931-455-2766

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	10/23/2007

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