Provider Demographics
NPI:1871524371
Name:HOLLADAY, WILLIAM D (OD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:HOLLADAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 ANTEBELLUM CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-0770
Mailing Address - Country:US
Mailing Address - Phone:615-947-0757
Mailing Address - Fax:615-354-5114
Practice Address - Street 1:6670 CHARLOTTE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4202
Practice Address - Country:US
Practice Address - Phone:615-354-5113
Practice Address - Fax:615-354-5114
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD0000002028152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU76087Medicare UPIN
TNU76087Medicare UPIN