MEDICARE: DR. MARY PATRICIA COLLINS M.D.

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	207W00000X	Ophthalmology Physician	MD0000019871	TN

General Provider Information

NPI Number	:	1508868894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY PATRICIA COLLINS M.D.

Provider Business Mailing Address
First Line	:	1928 ALCOA HWY
Second Line	:	STE 324
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-1502
Country	:	US
Telephone Number	:	865-524-9871
Fax Number	:	865-305-6955

Provider Business Practice Location Address
First Line	:	2547 WILLOW POINT WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37931-3162
Country	:	US
Telephone Number	:	865-244-2020
Fax Number	:	865-851-9352

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	04/27/2018

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