Provider Demographics
NPI:1194738674
Name:ROONEY, HOLLY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:ELIZABETH
Last Name:ROONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1100 E MONROE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLOBE
Mailing Address - State:AZ
Mailing Address - Zip Code:85501-1363
Mailing Address - Country:US
Mailing Address - Phone:928-425-3557
Mailing Address - Fax:928-425-3415
Practice Address - Street 1:703 E ASH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:GLOBE
Practice Address - State:AZ
Practice Address - Zip Code:85501-1865
Practice Address - Country:US
Practice Address - Phone:928-425-3557
Practice Address - Fax:928-425-3415
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2013-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZAZ28273207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ526519Medicaid
AZH27480Medicare UPIN
AZ63461Medicare ID - Type Unspecified