MEDICARE: JOSHUA MARK MCCOLLUM 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	207R00000X	Internal Medicine Physician	31962	TN
2	208000000X	Pediatrics Physician	31962	TN

General Provider Information

NPI Number	:	1942299359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA MARK MCCOLLUM MD

Provider Business Mailing Address
First Line	:	1253 ROCK SPRINGS RD
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-8365
Country	:	US
Telephone Number	:	615-790-7992
Fax Number	:	615-790-8688

Provider Business Practice Location Address
First Line	:	1253 ROCK SPRINGS RD
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-8365
Country	:	US
Telephone Number	:	615-813-2200
Fax Number	:	615-813-2373

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	09/05/2025

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