Provider Demographics
NPI:1265729719
Name:HOLLINGER, JASMINE C (MD)
Entity type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:C
Last Name:HOLLINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:114 COPPERRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-3700
Mailing Address - Country:US
Mailing Address - Phone:601-672-2044
Mailing Address - Fax:
Practice Address - Street 1:731 S PEAR ORCHARD RD STE 16
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4800
Practice Address - Country:US
Practice Address - Phone:601-672-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS23536207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP01590538OtherRAILROAD MEDICARE
MS07354043Medicaid
MS437275YJ5DMedicare PIN