MEDICARE: KIM A COLLINSON MD

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	207VG0400X	Gynecology Physician	MD17566	TN
2	208D00000X	General Practice Physician	MD17566	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902856990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM A COLLINSON MD

Provider Business Mailing Address
First Line	:	3815 HIGHWAY 66 S STE 5
Second Line	:
City	:	ROGERSVILLE
State	:	TN
Zip	:	37857-5197
Country	:	US
Telephone Number	:	423-293-0202
Fax Number	:	423-293-0102

Provider Business Practice Location Address
First Line	:	3815 HIGHWAY 66 S STE 5
Second Line	:
City	:	ROGERSVILLE
State	:	TN
Zip	:	37857-5197
Country	:	US
Telephone Number	:	423-293-0202
Fax Number	:	423-293-0102

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	02/04/2026

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Directions to “ KIM A COLLINSON MD” Practice Location

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