Organization
JACK L. HOLLINS, M.D., P.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK LYNN HOLLINS M.D. (OWNER)
(859) 264-7700
Entity
Organization
Contact information
Practice address
2353 ALEXANDRIA DR, SUITE 210, LEXINGTON, KY 40504-3287
(859) 264-7700
(859) 264-7744
Mailing address
2353 ALEXANDRIA DR, SUITE 210, LEXINGTON, KY 40504-3287
(859) 264-7700
(859) 264-7744
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
17380
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048591
ANTHEM PROVIDER ID
KY
01
—
180036565
RAILROAD MEDICARE ID
KY
Enumeration date
09/28/2006
Last updated
03/27/2015
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