Provider Demographics
NPI:1871986315
Name:HOLLOWAY, BARRY PAUL (PA-C)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:PAUL
Last Name:HOLLOWAY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 MARKET TRACE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-8694
Mailing Address - Country:US
Mailing Address - Phone:479-434-3600
Mailing Address - Fax:833-992-0797
Practice Address - Street 1:2707 MARKET TRACE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-8694
Practice Address - Country:US
Practice Address - Phone:479-434-3600
Practice Address - Fax:833-992-0797
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-602363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant