MEDICARE: DR. MICHAEL E HOLLINS II 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	2018030741	MO
2	152W00000X	Optometrist	009899	NY

General Provider Information

NPI Number	:	1922589894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL E HOLLINS II OD

Provider Business Mailing Address
First Line	:	2435 COMMERCE AVE BLDG 2200
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4980
Country	:	US
Telephone Number	:	770-822-3600
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 NW BARRY RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2728
Country	:	US
Telephone Number	:	816-468-4680
Fax Number	:

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

Provider Enumeration Date	:	08/28/2018
Last Update Date	:	02/21/2025

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