Provider Demographics
NPI:1740236611
Name:HOLLAND, ELIZABETH YEARGIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:YEARGIN
Last Name:HOLLAND
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 1:612 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4209
Mailing Address - Country:US
Mailing Address - Phone:864-312-3399
Mailing Address - Fax:864-312-3390
Practice Address - Street 1:612 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4209
Practice Address - Country:US
Practice Address - Phone:864-312-3399
Practice Address - Fax:864-312-3390
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH75457207W00000X
KY35107207W00000X
WI51555-020207W00000X
SC32509207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35280300Medicaid
OH2140525Medicaid
KY64964265Medicaid
WI000971057Medicare PIN
WI35280300Medicaid
KY0388409Medicare PIN
OH0880462Medicare PIN
WI000471505Medicare PIN
OH0880461Medicare PIN
OH180036248Medicare PIN
OHG96127Medicare UPIN
OH2140525Medicaid
WI000240230Medicare PIN
KY180037125Medicare PIN
WI000407760Medicare PIN