Individual
SHAY HOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5475 S 500 E, OGDEN, UT 84405-6905
(801) 479-2111
Mailing address
144 S 500 E, 2ND FLOOR, SALT LAKE CITY, UT 84102-1907
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
275093-1205
UT
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
275093-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
930085279
RAILROAD
UT
05
—
D0576
—
UT
Enumeration date
03/30/2006
Last updated
04/29/2010
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