Individual
ROBERT STERLING HOLLABAUGH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 GUTHRIE DR STE 102, SOUTHAVEN, MS 38671-5829
(662) 349-1964
(901) 763-4305
Mailing address
1325 WOLF PARK DR, SUITE 103, GERMANTOWN, TN 38138-1742
(901) 252-3411
(901) 384-6422
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
15804
MS
208800000X
Urology Physician
Primary
30313
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210025600
QUAL CHOICE
—
01
—
1201660
FIRST HEALTH
—
01
—
13137372
PHCS
—
01
—
133261
HEALTH LINK
—
01
—
3095141
BLUE CROSS
TN
05
—
3823224
—
TN
01
—
4025294
AETNA
—
01
—
4574106
CIGNA
—
01
—
97879
BLUE CROSS AR
—
Enumeration date
05/01/2006
Last updated
07/28/2023
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