Provider Demographics
NPI:1437187754
Name:ALDRIDGE, HOLLY H (MD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:H
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1500 OGLETHORPE AVE
Mailing Address - Street 2:BLDG 600 STE B
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2179
Mailing Address - Country:US
Mailing Address - Phone:706-549-3426
Mailing Address - Fax:706-549-3432
Practice Address - Street 1:1500 OGLETHORPE AVE
Practice Address - Street 2:BLDG 600 STE B
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2179
Practice Address - Country:US
Practice Address - Phone:706-549-3426
Practice Address - Fax:706-549-3432
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA053078208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA814410661AMedicaid