Provider Demographics
NPI:1689700965
Name:BILLUE AND HOLLEY PC
Entity Type:Organization
Organization Name:BILLUE AND HOLLEY PC
Other - Org Name:DAVID C BILLUE MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:BILLUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-571-8550
Mailing Address - Street 1:55 ROWE DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976
Mailing Address - Country:US
Mailing Address - Phone:256-571-8550
Mailing Address - Fax:256-571-8753
Practice Address - Street 1:55 ROWE DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976
Practice Address - Country:US
Practice Address - Phone:256-571-8550
Practice Address - Fax:256-571-8553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13710207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000018834Medicaid
AL000018834Medicaid
A98750Medicare UPIN