Individual
DR. MITCHELL J COLLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
609 E MAIN, LOCUST GROVE, OK 74352
(918) 479-8060
(918) 479-8066
Mailing address
PO BOX 1360, LOCUST GROVE, OK 74352-1360
(918) 479-8060
(918) 479-8066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22429
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001810A
—
OK
05
—
200001810C
—
OK
01
—
5N110
BCBS AR
AR
Enumeration date
05/11/2006
Last updated
07/13/2022
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