Provider Demographics
NPI:1891344289
Name:HOLLOWAY, JAMES EARL III
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EARL
Last Name:HOLLOWAY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 BRADYVILLE PIKE APT 1602
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-7830
Mailing Address - Country:US
Mailing Address - Phone:731-803-2409
Mailing Address - Fax:
Practice Address - Street 1:805 BRADYVILLE PIKE APT 1602
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-7830
Practice Address - Country:US
Practice Address - Phone:731-803-2409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program