Provider Demographics
NPI:1982980454
Name:HOLLAWAY EYE ASSOCIATES INC
Entity Type:Organization
Organization Name:HOLLAWAY EYE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOLLAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-334-3698
Mailing Address - Street 1:2300 N SALISBURY BLVD
Mailing Address - Street 2:STE K119
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7810
Mailing Address - Country:US
Mailing Address - Phone:410-334-3698
Mailing Address - Fax:443-260-1776
Practice Address - Street 1:2300 N SALISBURY BLVD
Practice Address - Street 2:STE K119
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7810
Practice Address - Country:US
Practice Address - Phone:410-334-3698
Practice Address - Fax:443-260-1776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2030152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty