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General NPI Number Information
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NPI Number | 1447519400
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Entity Type | Individual
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Provider Name | HOLLY DIANE CHAMBLISS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 750 PETER BRYCE BLVD
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City | TUSCALOOSA
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State | AL
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Zip | 35401
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Country | US
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Telephone | 205-348-6262
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Fax | 205-486-5232
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Provider Business Mailing Address
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Address Line | 904 26TH ST
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City | HALEYVILLE
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State | AL
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Zip | 35565-1719
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Country | US
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Telephone | 205-486-5234
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Fax | 205-486-5232
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD33201
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License Number State | AL
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