Healthcare Provider Details

I. General information

NPI: 1720496284
Provider Name (Legal Business Name): MICHAEL R HOLLAND MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 08/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR SUITE 100
JENNINGS LA
70546-3641
US

IV. Provider business mailing address

1 HOSPITAL DR SUITE 100
JENNINGS LA
70546-3641
US

V. Phone/Fax

Practice location:
  • Phone: 337-824-3819
  • Fax:
Mailing address:
  • Phone: 337-824-3819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MICHAEL R HOLLAND
Title or Position: OWNER
Credential: M.D.
Phone: 337-824-3819