Healthcare Provider Details

I. General information

NPI: 1649229741
Provider Name (Legal Business Name): JOHN B COLLIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

653 N TOWN CENTER DR STE 604
LAS VEGAS NV
89144-0520
US

IV. Provider business mailing address

400 N STEPHANIE ST STE 300
HENDERSON NV
89014-6692
US

V. Phone/Fax

Practice location:
  • Phone: 702-869-0855
  • Fax: 702-869-0859
Mailing address:
  • Phone: 702-952-3350
  • Fax: 702-952-3364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number7382
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number7382
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number7382
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: