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Individual

DR. ROBERT A DECOLLI JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
3360 N WATKINS ST, MEMPHIS, TN 38127-6405
(901) 401-7150
(901) 347-1285
Mailing address
PO BOX 746725, ATLANTA, GA 30374-6725
(312) 733-9730
(773) 866-8014

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4200
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015039900003
PA
01
110104720
RAILROAD MEDICARE
PA
Enumeration date
08/24/2005
Last updated
12/22/2025
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