MEDICARE: MRS. JEAN MARIE COLLINS D.O.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	05860	IA

General Provider Information

NPI Number	:	1790978518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JEAN MARIE COLLINS D.O.

Provider Business Mailing Address
First Line	:	907 E LAMAR ALEXANDER PKWY
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37804-5015
Country	:	US
Telephone Number	:	865-981-2335
Fax Number	:

Provider Business Practice Location Address
First Line	:	1408 6TH ST SW
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-4818
Country	:	US
Telephone Number	:	641-423-3903
Fax Number	:

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

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	01/13/2026

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