Provider Demographics
NPI:1063407351
Name:HOLLOWAY, CHRISTOPHER D (MD)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:D
Last Name:HOLLOWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4071 CANE RIDGE PKWY STE 112
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-2971
Mailing Address - Country:US
Mailing Address - Phone:615-731-8390
Mailing Address - Fax:615-731-8391
Practice Address - Street 1:4071 CANE RIDGE PKWY STE 112
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-2971
Practice Address - Country:US
Practice Address - Phone:615-731-8390
Practice Address - Fax:615-731-8391
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN36288207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810006246Medicaid
TN3875410Medicaid
TN080186281OtherRAILROAD MEDICARE
TN3875410Medicaid