MEDICARE: DR. JAMES D HOLLMANN OD

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	152W00000X	Optometrist	046011465	IL
2	152W00000X	Optometrist	TO3353	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000091096	OTHER	MO	MEDICARE DMEPOS
5	410038036	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	371265227	OTHER	MO	NUCROWN, INC. D/B/A CROWN OPTICAL
3	22-00861	OTHER	MO	UNITED HEALTHCARE
4	151258	OTHER	MO	BCBS OF MISSOURI

General Provider Information

NPI Number	:	1578533410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES D HOLLMANN OD

Provider Business Mailing Address
First Line	:	PO BOX 207163
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-7154
Country	:	US
Telephone Number	:	636-200-4393
Fax Number	:	636-527-0766

Provider Business Practice Location Address
First Line	:	1025 COLUMBIA CTR
Second Line	:
City	:	COLUMBIA
State	:	IL
Zip	:	62236-2546
Country	:	US
Telephone Number	:	618-281-8611
Fax Number	:	618-281-3927

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	10/21/2020

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Directions to “ DR. JAMES D HOLLMANN OD” Practice Location

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