Provider Demographics
NPI:1689818155
Name:HOLLINS, ANTHONY MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:HOLLINS
Suffix:
Gender:M
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 1000 DEPT 74
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-260-2072
Mailing Address - Fax:901-260-2077
Practice Address - Street 1:1264 WESLEY DR STE 302
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-6445
Practice Address - Country:US
Practice Address - Phone:901-260-2072
Practice Address - Fax:901-260-2077
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS23383207X00000X
TN51263207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06432026Medicaid
TNQ007961Medicaid
AR205193001Medicaid
TN6026508OtherBCBS