Provider Demographics
NPI:1902809635
Name:HOLLOWAY, KATHRYN B (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:B
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3233 SW 33RD RD
Mailing Address - Street 2:STE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-8468
Mailing Address - Country:US
Mailing Address - Phone:352-237-2322
Mailing Address - Fax:352-237-2456
Practice Address - Street 1:3233 SW 33RD RD
Practice Address - Street 2:STE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-8468
Practice Address - Country:US
Practice Address - Phone:352-237-2322
Practice Address - Fax:352-237-2456
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME66202207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME66202OtherSTATE LICENSE
FL28150Medicare ID - Type Unspecified
FLME66202OtherSTATE LICENSE