Clyde Frederick Hollon, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD000131151 Issued in WA

Practice address

801 W 5TH Ave
Suite 518
Spokane, WA 99204-2823

Phone

(509) 747-3147

Fax

(509) 747-0020

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spokane Urology PLLC

  • Urology Physician
  • Spokane, WA
  • NPI 1912015439
  NPD
• Spokane Urology PLLC

  • Durable Medical Equipment & Medical Supplies
  • Spokane Valley, WA
  • NPI 1538870134

  Urology

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1669589388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5447 S QUAIL RIDGE CIR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992236390",
            "telephone_number": "509-443-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W 5TH AVE",
            "address_2": "SUITE 518",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042823",
            "telephone_number": "509-747-3147",
            "fax_number": "509-747-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLON",
        "first_name": "CLYDE",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD000131151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L& I NUMBER",
            "identifier": "14965",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8249906",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "340011680",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andria Hollingshead, LMHP, LADC, CPC, NCC
• Katherine Anne Hollingsworth, LICSW, SUDP
• Holly Hollis, LMSW
• Rita Hollis
• Randall Steven Hollman, OTR
• Matthew Frederick Hollon, MD, MPH
• Mackenzie Paige Holloway, ARNP
• Sarah Ann Holloway
• Kevin Holly, CRNA
• Cassidy Holm

• Urology Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Urology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.