Healthcare Provider Details

I. General information

NPI: 1952403453
Provider Name (Legal Business Name): RALPH DUANE HOLLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S DEPARTMENT OF RADIOLOGY
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

3601 TVC
NASHVILLE TN
37232-0001
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-5340
  • Fax: 615-321-6322
Mailing address:
  • Phone: 615-322-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD0000036796
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD36796
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberMD36796
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: