Provider Demographics
NPI:1023208618
Name:HOLLIDAY, HUGH DOUGLAS JR
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:DOUGLAS
Last Name:HOLLIDAY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 EDMONDSON PIKE
Mailing Address - Street 2:#201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5872
Mailing Address - Country:US
Mailing Address - Phone:615-331-0402
Mailing Address - Fax:
Practice Address - Street 1:5505 EDMONDSON PIKE
Practice Address - Street 2:#201
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5872
Practice Address - Country:US
Practice Address - Phone:615-331-0402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN87111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice