Provider Demographics
NPI:1023177854
Name:TIERNEY, BRUCE COLLIER (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:COLLIER
Last Name:TIERNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 CARRINGTON POINTE
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-7342
Mailing Address - Country:US
Mailing Address - Phone:770-938-4277
Mailing Address - Fax:770-938-4277
Practice Address - Street 1:1712 CARRINGTON POINTE
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-7342
Practice Address - Country:US
Practice Address - Phone:404-464-0391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030230207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology