MEDICARE: DR. JANET L COLLIER O.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
1	152W00000X	Optometrist	T03317	MO

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	:	1982606695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET L COLLIER O.D.

Provider Business Mailing Address
First Line	:	15933 CLAYTON RD
Second Line	:	STE 201
City	:	BALLWIN
State	:	MO
Zip	:	63011-2172
Country	:	US
Telephone Number	:	636-200-4393
Fax Number	:	636-938-2650

Provider Business Practice Location Address
First Line	:	730 S KIRKWOOD RD
Second Line	:
City	:	KIRKWOOD
State	:	MO
Zip	:	63122-5929
Country	:	US
Telephone Number	:	314-821-2626
Fax Number	:

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	11/22/2017

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