Provider Demographics
NPI:1043291289
Name:H DOUGLAS HOLLIDAY MD PLLC
Entity type:Organization
Organization Name:H DOUGLAS HOLLIDAY MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:HOLLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-727-8796
Mailing Address - Street 1:2001 GLEN ECHO RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2807
Mailing Address - Country:US
Mailing Address - Phone:615-373-9505
Mailing Address - Fax:615-373-9505
Practice Address - Street 1:2001 GLEN ECHO RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2807
Practice Address - Country:US
Practice Address - Phone:615-727-8796
Practice Address - Fax:615-727-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4019725OtherBLUECROSS BLUESHIELD OF T
0440761OtherUNITED HEALTH CARE
4294542OtherAETNA
0002528OtherAMA
TN3170434Medicaid
B03402Medicare UPIN
TN4019725OtherBLUECROSS BLUESHIELD OF T