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Organization
COLLIER HMA PHYSICIAN MANAGEMENT LLC
Active
Organization
COLLIER HMA PHYSICIAN MANAGEMENT LLC
Active
Other names
Collier HMA Physician Management LLC, Physicians Regional Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
8340 COLLIER BLVD STE 103, NAPLES, FL 34114-3589
(239) 348-4420
(239) 348-4478
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275883123
—
FL
Enumeration date
06/16/2021
Last updated
03/08/2022
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