Individual
DR. COURTNEY ALLEN HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3512 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(765) 776-3100
(765) 453-8165
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01075640A
IN
207XP3100X
Pediatric Orthopaedic Surgery Physician
01075640A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201348570
—
IN
01
—
P01824484
RR MEDICARE
IN
Enumeration date
01/22/2007
Last updated
01/02/2024
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