Michael a Holy a Professional Medical Corporation

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

03517R Issued in LA

Legal business name

MICHAEL A HOLY A PROFESSIONAL MEDICAL CORPORATION

Practice address

1801 Fairfield Ave
Suite 101
Shreveport, LA 71101-4443

Phone

(318) 424-1617

Fax

(318) 424-1610

NPI assigned

Jun 9, 2006

Organization subpart

No

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

Authorized official

Name

Michael Adrian Holy, M.D.

Title

President

Phone

(318) 424-1617

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MICHAEL A HOLY MD Doing business as

Locations

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1790726693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE",
            "address_2": "SUITE 101",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014443",
            "telephone_number": "318-424-1617",
            "fax_number": "318-424-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE",
            "address_2": "SUITE 101",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014443",
            "telephone_number": "318-424-1617",
            "fax_number": "318-424-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A HOLY A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "HOLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ADRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-424-1617",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "03517R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1142239",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHAEL A HOLY MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cameron Meyer
• Kimberly E Meyer, PA-C
• D'Rasha Meyers
• Shawnette Meziere, PTA
• Maroun Mhanna, MD
• Michael E Woolbert DDS LLC
• Michael R. Wiesner DDS LLC
• Kristi C. Michael, MD
• Richard James Michael, MD
• Lee Michals, MD

• Ophthalmology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Ophthalmology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.