Provider Demographics
NPI:1588868392
Name:HOENES, HOLLY A (MD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:HOENES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 N LEE ST STE 164
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-2122
Mailing Address - Country:US
Mailing Address - Phone:478-994-6868
Mailing Address - Fax:478-994-6363
Practice Address - Street 1:164 N LEE ST STE 164
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-2122
Practice Address - Country:US
Practice Address - Phone:478-750-8880
Practice Address - Fax:478-750-8860
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67334208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA706246275AMedicaid
GA706246275BMedicaid
GA003122930CMedicaid
GA003122930AMedicaid