DR. WILLIAM RICHARD COLLIE IV (NPI# 1497923155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497923155 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM RICHARD COLLIE IV |
| Credential | M.D. |
| Practice Address |
17724 Interstate 30 Ste 2 Benton AR 72019-2907 |
| Mailing Address |
1201 Military Rd Ste 2 Pmb 269 Benton AR 72015-2908 |
| Practice Telephone | 5019207901 |
| Practice Fax Number | 5013253469 |
| Mailing Telephone | 5019207901 |
| Mailing Fax Number | 5013253469 |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2009-04-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
R-2220 | AR | Allopathic & Osteopathic Physicians |
| Street Address |
17724 INTERSTATE 30 STE 2 |
| City | BENTON |
| State | AR |
| Zip Code | 72019-2907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962631523 | Core Empowerment Group LLC | Clinic/Center | 17724 Interstate 30, Ste 2, Benton, AR 72019-2907 | 2009-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898293 | Arkansas Heart Hospital LLC | General Acute Care Hospital | 1901 Encore Way, Bryant, AR 72019 | 2020-10-16 |
| 1306485545 | Ryan Adams | Pharmacist | 20820 I-30 North, Benton, AR 72019 | 2020-01-06 |
| 1649819962 | Josh Landrum | Pharmacist | 20820 I 30 N, Benton, AR 72019 | 2020-01-03 |
| 1710525720 | Melanie Mabry | Nurse Practitioner | 11510 State Highway 298, Benton, AR 72019 | 2019-12-20 |
| 1578086864 | Ronald Winkler | Occupational Therapy Assistant | 2907 Hurricane Lake Rd, Bryant, AR 72019 | 2017-07-19 |
| 1801243357 | Richard Andrew Dwiggins | Social Worker | 1718 Old Hot Springs Highway, Benton, AR 72019 | 2016-05-14 |
| 1184008377 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 2080 I-30 North, Benton, AR 72019 | 2015-07-17 |
| 1689910051 | Rachel Cloud | Physical Therapist | 2010 Activeway, Benton, AR 72019 | 2012-12-12 |
| 1538444583 | Stacy Ann Harris | Specialist | 403 Demuth Lane, Benton, AR 72019 | 2011-10-20 |
| 1144528423 | Robert Mark Robinson | Licensed Practical Nurse | 5 Hickory Ridge Drive, Benton, AR 72019 | 2011-03-10 |
| Find all providers in zip 72019 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619179306 | Elizabeth Sellars | Medical Genetics | 1 Childrens Way # 512-22, Little Rock, AR 72202-3500 | 2007-06-04 |
| 1699983155 | Thomas Andrew Burrow | Medical Genetics | 1 Childrens Way, Slot 512-22, Little Rock, AR 72202-3500 | 2007-05-18 |
| 1407946064 | Mary Curtis | Medical Genetics | 800 Marshall St # 653, Little Rock, AR 72202-3510 | 2006-10-13 |
| 1225089204 | Gerald Bradley Schaefer | Medical Genetics | 2601 Gene George Blvd, Springdale, AR 72762-0845 | 2006-05-13 |
| 1457320913 | Adolfo D. Garnica | Medical Genetics | 1 Childrens Way # 653, Little Rock, AR 72202-3500 | 2006-03-16 |
Please comment or provide details below to improve the information on DR. WILLIAM RICHARD COLLIE IV.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.