Gerald Matthew Holloway, ATC
Individual provider Active NPI Athletic Trainer · Ludlow, KY
NPI 1457798696 · NPPES record last updated May 29, 2013
Key facts
- NPI
- 1457798696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT641 (OH)
- Practice address
- 427 Victoria St
Ludlow, KY 41016-1445 - Phone
- (859) 653-9404
- NPI assigned
- May 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT641 | OH | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT641 | OH | Yes |
Addresses
Primary practice location
427 Victoria St
Ludlow, KY 41016-1445
Mailing address
427 Victoria St
Ludlow, KY 41016-1445
Phone (859) 653-9404
Other providers in Ludlow, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.