Provider Demographics
NPI:1982671582
Name:HOLLAND, HENRY KENT (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:KENT
Last Name:HOLLAND
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 1:5670 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1704
Mailing Address - Country:US
Mailing Address - Phone:404-255-1930
Mailing Address - Fax:404-459-8510
Practice Address - Street 1:5670 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 1000
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1704
Practice Address - Country:US
Practice Address - Phone:404-255-1930
Practice Address - Fax:404-459-8510
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034614174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000466166DMedicaid
GA000466166DMedicaid