Provider Demographics
NPI:1841496239
Name:HOWARD R HOLADAY, M.D., P.A.
Entity type:Organization
Organization Name:HOWARD R HOLADAY, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-680-8383
Mailing Address - Street 1:614 TCHOUPITOULAS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-3212
Mailing Address - Country:US
Mailing Address - Phone:504-680-8383
Mailing Address - Fax:
Practice Address - Street 1:5903 RIDGEWOOD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-3700
Practice Address - Country:US
Practice Address - Phone:601-982-8121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11213207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0111758Medicaid
MSE14395Medicare UPIN