Healthcare Provider Details

I. General information

NPI: 1598861999
Provider Name (Legal Business Name): GARY F HOLLAND MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 N MAIN ST STE 103
KAYSVILLE UT
84037-1272
US

IV. Provider business mailing address

375 N MAIN ST STE 103
KAYSVILLE UT
84037-1272
US

V. Phone/Fax

Practice location:
  • Phone: 801-876-3749
  • Fax: 801-876-3687
Mailing address:
  • Phone: 801-876-3749
  • Fax: 801-876-3687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3088050-1205
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY HOLLAND
Title or Position: DR OF MEDICINE
Credential: M.D.
Phone: 801-876-3749