Healthcare Provider Details

I. General information

NPI: 1942299359
Provider Name (Legal Business Name): JOSHUA MARK MCCOLLUM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1253 ROCK SPRINGS RD
SMYRNA TN
37167-8365
US

IV. Provider business mailing address

1253 ROCK SPRINGS RD
SMYRNA TN
37167-8365
US

V. Phone/Fax

Practice location:
  • Phone: 615-813-2200
  • Fax: 615-813-2373
Mailing address:
  • Phone: 615-813-2200
  • Fax: 615-813-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number31962
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31962
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: