Basic Information
| Provider Information | |||||||||
| NPI: | 1508868894 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COLLINS | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | PATRICIA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1928 ALCOA HWY | ||||||||
| Address2: | STE 324 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379201502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655249871 | ||||||||
| FaxNumber: | 8653056955 | ||||||||
| Practice Location | |||||||||
| Address1: | 2547 WILLOW POINT WAY | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379313162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652442020 | ||||||||
| FaxNumber: | 8658519352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 04/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | MD0000019871 | TN | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.