Jeffrey N Holley MD PC
Organization Active NPI Legal Medicine · Donalsonville, GA
NPI 1770620098 · NPPES record last updated Oct 24, 2007
Key facts
- NPI
- 1770620098
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Legal Medicine 173000000X
- License
- 038013 (GA)
- Legal business name
- JEFFREY N HOLLEY MD PC
- Practice address
- 214 Cherry St
Donalsonville, GA 39845-1616 - Phone
- (229) 524-2232
- Fax
- (229) 524-8766
- NPI assigned
- Jan 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Jeffrey Neal Holley, MD
- Title
- President
- Phone
- (229) 524-2232
Practitioners 2
-
Jacob Harvey Holley III, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0720419 | Jeffrey N Holley MD PC | Certificate of waiver | Apr 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041108000630 | GA | Part B Supplier - Clinic/Group Practice | 9739142092 |
Receives reassigned benefits from 2 practitioners Practice locations: Donalsonville, GA |
National Provider Directory
Locations
102 Hospital Cir
Donalsonville, GA 39845
Phone (229) 524-8489
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine |
173000000X | 038013 | GA | Yes |
Addresses
Primary practice location
214 Cherry St
Donalsonville, GA 39845-1616
Mailing address
PO Box 637
Donalsonville, GA 39845-0637
Phone (229) 524-2232
Other providers in Donalsonville, GA
- Tukessa M Hopson
- Leslie Brooke Hornsby
- Mary M. Hunt
- Richard Owen Hunt
- Cintorra Jackson
- Ashton Pyle Jester
- Lasheika Jones
- Just a Friend LLC
- Vincent Kelley
- Lakesha Kimble
All providers in Donalsonville, GA · Legal Medicine in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.