Provider Demographics
NPI:1528028875
Name:HOLLOWAY, JOHN HOLCOMBE III
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HOLCOMBE
Last Name:HOLLOWAY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:H
Other - Last Name:HOLLOWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2147 RIVERCHASE OFFICE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1836
Mailing Address - Country:US
Mailing Address - Phone:205-403-8902
Mailing Address - Fax:205-982-7882
Practice Address - Street 1:101 PAYNE RD
Practice Address - Street 2:AMERICAN FAMILY CARE INC
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071
Practice Address - Country:US
Practice Address - Phone:205-631-6834
Practice Address - Fax:205-631-0273
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6733207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00153615OtherRAILROAD MEDICARE
AL51051467OtherBLUE CROSS BLUE SHIELD
ALP00153615OtherRAILROAD MEDICARE