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General NPI Number Information
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NPI Number | 1326099557
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Entity Type | Organization
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Legal Business Name | JOSEPH B HOLLIS MD PC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 1211 RODMAN AVE
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City | PORTSMOUTH
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State | VA
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Zip | 23707-3915
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Country | US
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Telephone | 757-397-2493
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Fax | 757-397-7189
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Provider Business Mailing Address
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Address Line | 1211 RODMAN AVE
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City | PORTSMOUTH
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State | VA
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Zip | 23707-3915
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Country | US
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Telephone | 757-397-2493
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Fax | 757-397-7189
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH B HOLLIS
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Credential | MD
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Telephone | 757-397-2493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0101028352
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License Number State | VA
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