MEDICARE: THOMAS H HOLLIS JR. 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	208M00000X	Hospitalist Physician	E-1842	AR
2	207Q00000X	Family Medicine Physician	E 1842	AR

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

General Provider Information

NPI Number	:	1831190339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS H HOLLIS JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 21850
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71903-1850
Country	:	US
Telephone Number	:	501-627-1800
Fax Number	:	501-627-1899

Provider Business Practice Location Address
First Line	:	1 MERCY LN
Second Line	:	SUITE 201
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6442
Country	:	US
Telephone Number	:	501-609-2222
Fax Number	:	501-321-9689

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	03/20/2018

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