Provider Demographics
NPI:1528556362
Name:ABLES, HOLLIE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:HOLLIE
Middle Name:ELIZABETH
Last Name:ABLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5392
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-5392
Mailing Address - Country:US
Mailing Address - Phone:601-703-3018
Mailing Address - Fax:601-703-9283
Practice Address - Street 1:252 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MS
Practice Address - Zip Code:39345-9756
Practice Address - Country:US
Practice Address - Phone:601-683-3117
Practice Address - Fax:601-683-2505
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC52618207QA0000X
390200000X
MS29082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS005556231Medicaid