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Individual

MR. WALTER R HOLLOWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
181 N KENTUCKY ST STE 200, WEST PLAINS, MO 65775-2089
(417) 255-8337
(417) 255-2720
Mailing address
181 N KENTUCKY ST STE 200, WEST PLAINS, MO 65775-2089
(417) 255-8337
(417) 255-2720

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
110894
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100049
BC/BS
MO
05
130543001
AR
05
208541805
MO
05
506131408
MO
Enumeration date
09/20/2006
Last updated
09/20/2011
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