Individual
MICHAEL A HOLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 FAIRFIELD AVE, STE 101, SHREVEPORT, LA 71101-4457
(318) 424-1617
(318) 424-1610
Mailing address
1801 FAIRFIELD AVE, STE 101, SHREVEPORT, LA 71101-4457
(318) 424-1617
(318) 424-1610
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
03517R
LA
207W00000X
Ophthalmology Physician
D4157
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1142239
—
LA
Enumeration date
06/21/2005
Last updated
02/28/2008
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