Individual
DR. HOLLY LORRAINE HUBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4495 ATLANTA HWY, BUILDING 200, LOGANVILLE, GA 30052-6736
(770) 710-0117
(470) 223-4229
Mailing address
4495 ATLANTA HWY, SUITE 200, LOGANVILLE, GA 30052-6736
(770) 710-0117
(470) 223-4229
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101246331
VA
208000000X
Pediatrics Physician
Primary
64814
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00304545D
—
GA
Enumeration date
10/02/2008
Last updated
07/09/2014
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