Individual
JACOB COLLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4881 SUGAR MAPLE DR, DAYTON, OH 45433-5529
(937) 257-2785
Mailing address
5301 VIRGINIA WAY STE 300, BRENTWOOD, TN 37027-7542
(615) 221-4400
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0102207658
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
1412
NE
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
5249
TN
208D00000X
General Practice Physician
1412
NE
Other
Enumeration date
06/25/2014
Last updated
12/18/2025
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