Healthcare Provider Details

I. General information

NPI: 1447519400
Provider Name (Legal Business Name): HOLLY DIANE CHAMBLISS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY SLATTON MCCALEB M.D.

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 PETER BRYCE BLVD
TUSCALOOSA AL
35401
US

IV. Provider business mailing address

904 26TH ST
HALEYVILLE AL
35565-1719
US

V. Phone/Fax

Practice location:
  • Phone: 205-348-6262
  • Fax: 205-486-5232
Mailing address:
  • Phone: 205-486-5234
  • Fax: 205-486-5232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD33201
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: