Healthcare Provider Details

I. General information

NPI: 1699731091
Provider Name (Legal Business Name): STEVEN COLLIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HIGHWAY 64 E
AUGUSTA AR
72006-5150
US

IV. Provider business mailing address

PO BOX 277
AUGUSTA AR
72006-0277
US

V. Phone/Fax

Practice location:
  • Phone: 870-347-2508
  • Fax: 870-347-5556
Mailing address:
  • Phone: 870-347-3300
  • Fax: 870-347-3492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11515
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14898
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC5781
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: