Individual
LLOYD R HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
444 FOUR STATES DR, SUITE 1, GALENA, KS 66739-4324
(620) 783-4441
(620) 783-4090
Mailing address
PO BOX 2546, JOPLIN, MO 64803-2546
(620) 783-4441
(620) 783-4090
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1501269
KS
363A00000X
Physician Assistant
2001005636
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100390890B
—
KS
05
—
100390890E
—
KS
Enumeration date
06/22/2006
Last updated
01/05/2012
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