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General NPI Number Information
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NPI Number | 1407198179
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Entity Type | Individual
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Provider Name | HOLLEY LEONA DAVIS MD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 605 GLENWOOD DR STE 300
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1144
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Country | US
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Telephone | 423-495-2690
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Fax | 423-495-2698
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Provider Business Mailing Address
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Address Line | 12101 WOODCREST EXECUTIVE DR SUITE 210
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City | SAINT LOUIS
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State | MO
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Zip | 63141-5047
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Country | US
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Telephone | 314-317-0600
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Fax | 314-317-0606
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2016021070
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 57539
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License Number State | TN
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