Basic Information
Provider Information
NPI: 1902885221
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLLEY
FirstName: STEVEN
MiddleName: JOSHUA
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2900 LAMB CIR
Address2:  
City: CHRISTIANSBURG
State: VA
PostalCode: 240736344
CountryCode: US
TelephoneNumber: 5407312000
FaxNumber:  
Practice Location
Address1: 2900 LAMB CIR
Address2:  
City: CHRISTIANSBURG
State: VA
PostalCode: 240736344
CountryCode: US
TelephoneNumber: 5407312000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/13/2006
LastUpdateDate: 07/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000X0102202179VAY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


Home