Individual
DR. BERT DAVID COLLIER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1675 E MAIN ST, BOX 328, KENT, OH 44240-5818
(330) 593-1030
(330) 572-3836
Mailing address
1675 E MAIN ST, BOX 328, KENT, OH 44240-5818
(330) 677-3632
(330) 572-3836
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.079929
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497798
—
OH
01
—
CO555348
HIGHMARK
PA
Enumeration date
06/23/2006
Last updated
08/29/2016
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