Individual
JOHN HOLLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 DOCTORS PARK, STARKVILLE, MS 39759-2174
(662) 323-2515
(662) 323-2557
Mailing address
103 DOCTORS PARK, STARKVILLE, MS 39759-2174
(662) 323-2515
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9135
MS
207Q00000X
Family Medicine Physician
Primary
9135
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010599
—
MS
01
—
009979570
ALABAMA MEDICAID
MS
01
—
562251777
BLUE CROSS
MS
Enumeration date
06/13/2006
Last updated
01/14/2026
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