Holladay, Bruce Robert

Holladay, Bruce Robert is an individual health care provider with primary practice located at 560 S Loop Rd , Edgewood KY 41017-3405. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Holladay, Bruce Robert can be contacted via phone (859) 301-2663.

Contact Information

Primary practice address
560 S Loop Rd Edgewood KY 41017-3405
Phone: (859) 301-2663
Fax: (859) 301-0655
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 29856 Kentucky
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 29856 Kentucky

Profile Details

NPI number 1548262793
LBN Legal business name Holladay, Bruce Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Feb 3rd, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548262793 NPPES
Kentucky Other 000000249593 ANTHEM
Kentucky MEDICAID 64298565 ANTHEM
Kentucky Other 90008962 ANTHEM
Kentucky Other 428850004 ANTHEM
Kentucky Other 200045151 ANTHEM

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