Provider Demographics
NPI:1194731554
Name:COLLIER, ROBERT RIAH JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:RIAH
Last Name:COLLIER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3635 POINT COMFORT CLUB RD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-9597
Mailing Address - Country:US
Mailing Address - Phone:706-863-0905
Mailing Address - Fax:
Practice Address - Street 1:AUGUSTA VAMC
Practice Address - Street 2:1 FREEDOM WAY
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-481-6791
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA040643207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA040643OtherLICENSE #
GA040643OtherLICENSE #