Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 17672 | MS |
NPI | 1053335372 |
---|---|
Provider Name | Dr. Harry R Holliday |
First Address | Starkville, MS 39759-2163 |
Second Address | Starkville, MS 39759-2521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 06/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00200336 | (05) | MS |
I65030 | (02) | MS |