| Doctor Name: | DR. JOHN O HOLLOSZY |
| NPI Number: | 1922202886 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | R2190 |
| Business Practice Address: | 4566 Scott Ave Campus Box 8113 Saint Louis, MO - 631101031 |
| Business Phone Number: | 3143623506 |
| Business Fax Number: | 3143627657 |
| Mailing Address: | 4566 Scott Ave, Campus Box 8113 SAINT LOUIS |
| State: | MO |
| Postal Code: | 631101031 |
| Phone Number: | 3143623506 |
| Fax Number: | 3143627657 |
| NPI Enumeration Date: | 06/13/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | R2190 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |