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1659321529

NPI Code Detail

MEDICARE: CLINTON T HOLLADAY MD

MEDICARE: CLINTON T HOLLADAY MD

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	2085R0001X	Radiation Oncology Physician	00027196	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	515-33333	OTHER	AL	BLUE CROSS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	515-33331	OTHER	AL	BLUE CROSS
7	511-65663	OTHER	AL	BLUE CROSS
8	P00338341	OTHER	AL	RRMC

General Provider Information

NPI Number	:	1659321529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLINTON T HOLLADAY MD

Provider Business Mailing Address
First Line	:	2000A SOUTHBRIDGE PKWY
Second Line	:	STE 300
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-7718
Country	:	US
Telephone Number	:	205-871-4274
Fax Number	:	205-871-4301

Provider Business Practice Location Address
First Line	:	701 PRINCETON AVE SW
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35211-1303
Country	:	US
Telephone Number	:	205-783-3000
Fax Number	:	205-871-4301

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	12/30/2015

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Directions to “ CLINTON T HOLLADAY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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