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General NPI Number Information
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NPI Number | 1982980454
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Entity Type | Organization
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Legal Business Name | HOLLAWAY EYE ASSOCIATES INC
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Dates
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Enumeration Date | 10/28/2011
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 2300 N SALISBURY BLVD STE K119
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City | SALISBURY
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State | MD
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Zip | 21801-7810
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Country | US
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Telephone | 410-334-3698
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Fax | 443-260-1776
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Provider Business Mailing Address
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Address Line | 2300 N SALISBURY BLVD STE K119
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City | SALISBURY
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State | MD
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Zip | 21801-7810
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Country | US
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Telephone | 410-334-3698
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Fax | 443-260-1776
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JOSEPH C. HOLLAWAY
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Credential | O.D.
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Telephone | 410-334-3698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA2030
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License Number State | MD
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