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NPI Code Detail

MEDICARE: DR. JEANINE SHANNON-ALLISON COLLIER M.D.

MEDICARE: DR. JEANINE SHANNON-ALLISON COLLIER M.D.
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
12084P0800XPsychiatry PhysicianMD21368OR

Other Identifiers

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

General Provider Information

NPI Number : 1427166487
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEANINE SHANNON-ALLISON COLLIER M.D.
Provider Business Mailing Address
First Line : 281 LACLAIR ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2988
Country : US
Telephone Number : 541-266-6700
Fax Number : 541-888-8726
Provider Business Practice Location Address
First Line : 281 LACLAIR ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2988
Country : US
Telephone Number : 541-266-6700
Fax Number : 541-888-8726
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 02/19/2020

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