Individual
DR. HOLLY R INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840
(719) 524-2273
(719) 333-1249
Mailing address
5930 BAY SPRINGS LN, COLORADO SPRINGS, CO 80918-8136
(817) 851-7599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A-1600-11
NM
207Q00000X
Family Medicine Physician
Primary
DR.0057385
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293167702
—
TX
01
—
8ED361
BCBS
TX
Enumeration date
01/05/2011
Last updated
10/30/2023
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