Provider Demographics
NPI:1093754541
Name:HOLLOWAY, GEORGE ALLEN JR (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ALLEN
Last Name:HOLLOWAY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2929 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-8034
Mailing Address - Country:US
Mailing Address - Phone:602-344-5611
Mailing Address - Fax:
Practice Address - Street 1:14973 W BELL RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3236
Practice Address - Country:US
Practice Address - Phone:623-934-1245
Practice Address - Fax:623-934-3598
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ176222086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD33721Medicare UPIN