Provider Demographics
NPI:1275050882
Name:HOLLY N PAPANEK DO LLC
Entity Type:Organization
Organization Name:HOLLY N PAPANEK DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLL
Authorized Official - Middle Name:N
Authorized Official - Last Name:PAPANEK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-470-3285
Mailing Address - Street 1:PO BOX 631736
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1736
Mailing Address - Country:US
Mailing Address - Phone:937-470-3284
Mailing Address - Fax:513-855-3030
Practice Address - Street 1:514 HIGH ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:45068-9784
Practice Address - Country:US
Practice Address - Phone:937-470-3285
Practice Address - Fax:513-855-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty