Individual
THEODORE F HOLLAND III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8240 NAAB ROAD, SUITE 200, INDIANAPOLIS, IN 46260-1986
(317) 876-2330
(317) 876-2320
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 890-2000
(317) 859-4269
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01026261A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000351008
ANTHEM PROVIDER NUMBER
IN
05
—
100065120
—
IN
Enumeration date
07/28/2006
Last updated
03/16/2021
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