MEDICARE: TIMOTHY ALLAN COLLARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347E00000X	Transportation Broker	5802000150	MI

General Provider Information

NPI Number	:	1023942463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY ALLAN COLLARD

Provider Business Mailing Address
First Line	:	903 VALLEY VIEW DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49685-8744
Country	:	US
Telephone Number	:	231-499-0269
Fax Number	:	231-499-0269

Provider Business Practice Location Address
First Line	:	903 VALLEY VIEW DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49685-8744
Country	:	US
Telephone Number	:	231-499-0269
Fax Number	:	231-499-0269

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “ TIMOTHY ALLAN COLLARD ” Practice Location

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