Provider Demographics
NPI:1154419414
Name:HOLLEMAN, DONALD RAY JR (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RAY
Last Name:HOLLEMAN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:UK DIVISION OF INFECTIOUS DISEASES
Mailing Address - Street 2:740 S. LIMESTONE, K512 KY CLINIC
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-8178
Mailing Address - Fax:859-323-8926
Practice Address - Street 1:UK DIVISION OF INFECTIOUS DISEASES
Practice Address - Street 2:740 S. LIMESTONE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-323-5544
Practice Address - Fax:859-323-8926
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2016-07-08
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Provider Licenses
StateLicense IDTaxonomies
KY29199207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64291990Medicaid
KYE04323Medicare UPIN
KY0054805Medicare ID - Type Unspecified