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General NPI Number Information
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NPI Number | 1477879815
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Entity Type | Individual
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Provider Name | VICTORIA HOLIDAY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 220 ABRAHAM FLEXNER WAY STE 606
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City | LOUISVILLE
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State | KY
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Zip | 40202-3826
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Country | US
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Telephone | 502-582-7654
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Fax | 502-587-4117
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Provider Business Mailing Address
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Address Line | 3710 SW US VETERANS HOSPITAL RD
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City | PORTLAND
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State | OR
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Zip | 97239-2964
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Country | US
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Telephone | 503-494-7243
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 49225
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License Number State | KY
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