Healthcare Provider Details
I. General information
NPI: 1942285580
Provider Name (Legal Business Name): ROBERT LLOYD COLLIER D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/07/2005
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 1ST DR NW
AUSTIN MN
55912-2941
US
IV. Provider business mailing address
1000 1ST DR NW
AUSTIN MN
55912-2941
US
V. Phone/Fax
- Phone: 507-434-1092
- Fax: 507-434-1477
- Phone: 507-434-1092
- Fax: 507-434-1477
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 484 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: