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General NPI Number Information
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NPI Number | 1386926236
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Entity Type | Individual
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Provider Name | TREVOR J HOLLAND M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 3906 S DUPONT SQ
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City | LOUISVILLE
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State | KY
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Zip | 40207-4647
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Country | US
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Telephone | 122-823-8998
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Fax | 812-282-4172
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Provider Business Mailing Address
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Address Line | 1650 W HARRISON ST SUITE 466 ATRIUM
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City | CHICAGO
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State | IL
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Zip | 60612-3800
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Country | US
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Telephone | 312-942-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 01080516A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 51390
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License Number State | KY
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