Provider Demographics
NPI:1104197276
Name:HOLLEN, JOSEPH R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:HOLLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOE
Other - Middle Name:R
Other - Last Name:HOLLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 6629
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89513-6629
Mailing Address - Country:US
Mailing Address - Phone:775-827-0670
Mailing Address - Fax:775-827-6481
Practice Address - Street 1:4741 CAUGHLIN PKWY
Practice Address - Street 2:SUITE #3
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-1000
Practice Address - Country:US
Practice Address - Phone:775-827-0670
Practice Address - Fax:775-827-6481
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4392207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine