Provider Demographics
NPI:1417940073
Name:HOLLAND, DONALD JOE (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:JOE
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97790
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-7790
Mailing Address - Country:US
Mailing Address - Phone:480-949-5700
Mailing Address - Fax:480-949-8976
Practice Address - Street 1:7514 E MONTEREY WAY
Practice Address - Street 2:SUITE 4
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6900
Practice Address - Country:US
Practice Address - Phone:480-949-5700
Practice Address - Fax:480-949-8796
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ193462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ19346OtherMEDICAL LICENSE
BH1079234OtherDEA NO
AZ19346OtherMEDICAL LICENSE
AZZ109402Medicare PIN