Physician Compare National (NPI:1760667570)

HEALTHCARE PROVIDER: JASON SAMUEL COLLIER DDS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1760667570
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1355618794
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170606002144
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COLLIER
	Individual professional last name
Provider First Name	JASON
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	THE DENTAL SCHOOL AT UNIVERSITY OF TEXAS HSC AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	850 WILLOW TREE CIR
	Group Practice or individual's line 1 address
City	CORDOVA
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	380186376
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y