MEDICARE: MICHAEL R. HOLLAND, M.D., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician
2	174400000X	Specialist

General Provider Information

NPI Number	:	1134963697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL R. HOLLAND, M.D., INC.

Provider Business Mailing Address
First Line	:	1 HOSPITAL DRIVE, SUITE 100
Second Line	:
City	:	JENNINGS
State	:	LA
Zip	:	70546-3641
Country	:	US
Telephone Number	:	337-824-3819
Fax Number	:	337-824-0160

Provider Business Practice Location Address
First Line	:	1 HOSPITAL DRIVE, SUITE 100
Second Line	:
City	:	JENNINGS
State	:	LA
Zip	:	70546-3641
Country	:	US
Telephone Number	:	337-824-3819
Fax Number	:	337-824-0160

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MICHAEL RYBURN HOLLAND
Credential	:	M.D.
Telephone Number	:	337-824-3818

Provider Enumeration Date	:	06/20/2024
Last Update Date	:	06/20/2024

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