Basic Information
| Provider Information | |||||||||
| NPI: | 1154732436 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLLINS | ||||||||
| FirstName: | MARCUM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | COLLINS | ||||||||
| OtherFirstName: | MARC | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1924 ALCOA HWY | ||||||||
| Address2: | DEPARTMENT OF MEDICINE U-114 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379201511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8653059340 | ||||||||
| FaxNumber: | 8653059144 | ||||||||
| Practice Location | |||||||||
| Address1: | THE WHITAKER CLINIC OF UAB HOSPITAL | ||||||||
| Address2: | 500 22ND STREET SOUTH | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352333110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059308347 | ||||||||
| FaxNumber: | 2059308340 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2014 | ||||||||
| LastUpdateDate: | 05/14/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RR0500X | MD.36162 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.