Individual
JONATHAN HOLLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
590 NEWARK GRANVILLE RD, GRANVILLE, OH 43023-1436
(888) 531-7444
Mailing address
590 NEWARK GRANVILLE RD, GRANVILLE, OH 43023-1436
(888) 531-7444
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
35-08-4535
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2612917
—
OH
Enumeration date
03/07/2006
Last updated
08/14/2014
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