Doctor Name: | DR. JOHN TEDDY HOLLOWAY |
NPI Number: | 1144549734 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 016077 |
Business Practice Address: | 549 Creek Dr Hoboken, GA - 315422959 |
Business Phone Number: | 9124582494 |
Business Fax Number: | |
Mailing Address: | 549 Creek Dr, HOBOKEN |
State: | GA |
Postal Code: | 315422959 |
Phone Number: | 9124582494 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2010 |
NPI Last Update Date: | 05/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 016077 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |