Doctor Name: | JAMES BENTLEY HOLLINSHEAD |
NPI Number: | 1104811884 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A. |
License Number: | 30363 |
Business Practice Address: | 3 Albert Cree Dr Rutland, VT - 057014601 |
Business Phone Number: | 8027752937 |
Business Fax Number: | 8027730934 |
Mailing Address: | 3 Albert Cree Dr, RUTLAND |
State: | VT |
Postal Code: | 057014601 |
Phone Number: | 8027752937 |
Fax Number: | 8027730934 |
NPI Enumeration Date: | 09/19/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 30363 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |