Provider Demographics
NPI:1235119264
Name:HOLLIER, JOHN WILLIAM (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:HOLLIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6775 MOLLY VIEW PT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2111
Mailing Address - Country:US
Mailing Address - Phone:770-354-6412
Mailing Address - Fax:770-781-5103
Practice Address - Street 1:178 BRACKETTS WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-2984
Practice Address - Country:US
Practice Address - Phone:706-745-2020
Practice Address - Fax:770-781-5103
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000784152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000069825AMedicaid
GA41ZCBMSMedicare PIN
GA000069825AMedicaid