Basic Information
| Provider Information | |||||||||
| NPI: | 1003011180 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLLON | ||||||||
| FirstName: | JUSTIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 620 JOHN PAUL JONES CIRCLE | ||||||||
| Address2: | NAVAL MEDICAL CENTER PORTSMOUTH | ||||||||
| City: | PORTSMOUTH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7579534529 | ||||||||
| FaxNumber: | 7579533293 | ||||||||
| Practice Location | |||||||||
| Address1: | 620 JOHN PAUL JONES CIRCLE | ||||||||
| Address2: | NAVAL MEDICAL CENTER PORTSMOUTH | ||||||||
| City: | PORTSMOUTH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7579534529 | ||||||||
| FaxNumber: | 7579533293 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2007 | ||||||||
| LastUpdateDate: | 04/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0206X | 0101244427 | VA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology |
No ID Information.