Individual
JACK L. COLLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4050 W MEMORIAL RD FL 3, OKLAHOMA CITY, OK 73120-8382
(405) 608-3800
(405) 608-1240
Mailing address
7800 NW 85TH TER, OKLAHOMA CITY, OK 73132-3385
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
24868
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200162400A
—
OK
Enumeration date
02/07/2007
Last updated
06/06/2022
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