1144426305 NPI number — DR. HUGH DOUGLAS HOLLIDAY MD

Table of content: DR. HUGH DOUGLAS HOLLIDAY MD (NPI 1144426305)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144426305 NPI number — DR. HUGH DOUGLAS HOLLIDAY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLLIDAY
Provider First Name:
HUGH
Provider Middle Name:
DOUGLAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOLLIDAY
Provider Other First Name:
H
Provider Other Middle Name:
DOUGLAS
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1144426305
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4230 HARDING PIKE
Provider Second Line Business Mailing Address:
STE 801
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37205-2018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-297-6006
Provider Business Mailing Address Fax Number:
615-298-6778

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4230 HARDING RD
Provider Second Line Business Practice Location Address:
STE. 530 HEART INSTITUTE
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37205-2013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-297-6006
Provider Business Practice Location Address Fax Number:
615-298-6778
Provider Enumeration Date:
06/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  10586 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00475140 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4161542 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 31704301 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4294542 . This is a "AETNA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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