Healthcare Provider Details

I. General information

NPI: 1720600794
Provider Name (Legal Business Name): JOSHUA HOLLINGSHEAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 PIERCE ST STE 402
SIOUX CITY IA
51104-3766
US

IV. Provider business mailing address

2730 PIERCE ST STE 402
SIOUX CITY IA
51104-3766
US

V. Phone/Fax

Practice location:
  • Phone: 712-234-8725
  • Fax: 712-234-8728
Mailing address:
  • Phone: 712-234-8725
  • Fax: 712-234-8728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD-56964
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number94-10202
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: