Provider Demographics
NPI:1225220460
Name:HOLLEMAN SURGICAL
Entity Type:Organization
Organization Name:HOLLEMAN SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BENNETT
Authorized Official - Last Name:HOLLEMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:828-894-3300
Mailing Address - Street 1:44 HOSPITAL DR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-8516
Mailing Address - Country:US
Mailing Address - Phone:828-894-3300
Mailing Address - Fax:828-894-3377
Practice Address - Street 1:44 HOSPITAL DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-8516
Practice Address - Country:US
Practice Address - Phone:828-894-3300
Practice Address - Fax:828-894-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-12
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98-00281208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1140XOtherBLUE CROSS BLUE SHIELD
DF0716OtherRAILROAD MEDICARE
NC89066RKMedicaid
SCNPB117Medicaid
2348454Medicare PIN