Individual
LARRY ARRAY HOLLAR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1188 YADKINVILLE RD, MOCKSVILLE, NC 27028-2037
(367) 167-4353
(336) 702-9277
Mailing address
PROVIDER ENROLLMENT, 100 KIMEL FOREST DRIVE, WINSTON SALEM, NC 27103-6074
(336) 713-0947
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
98-00910
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127R4
BLUE CROSS BLUE SHIELD
NC
05
—
89127R4
—
NC
Enumeration date
10/17/2006
Last updated
10/23/2023
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