Provider Demographics
NPI:1548281124
Name:COLLER, ZACHARY V (MD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:V
Last Name:COLLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5002 CROSSINGS CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-8471
Mailing Address - Country:US
Mailing Address - Phone:615-515-9111
Mailing Address - Fax:615-758-3791
Practice Address - Street 1:5002 CROSSINGS CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-8471
Practice Address - Country:US
Practice Address - Phone:615-515-9111
Practice Address - Fax:615-758-3791
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN47831207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1526457Medicaid
OH2815636Medicaid
TNP01004445OtherRR MEDICARE
TN4312933OtherBCBS
TN4312933OtherBCBS
MO959173268Medicare PIN
TN103I290376Medicare PIN