Holladay, Dawnetta Janene

Holladay, Dawnetta Janene is an individual health care provider with primary practice located at 1620 Prince Ave , Athens GA 30606-6008. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is her primary health care specialty. Holladay, Dawnetta Janene can be contacted via phone (706) 549-8114.

Contact Information

Primary practice address
1620 Prince Ave Athens GA 30606-6008
Phone: (706) 549-8114
Fax: (706) 549-0151
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207LA0401X 37199 Georgia
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 037199 Georgia

Profile Details

NPI number 1619958790
LBN Legal business name Holladay, Dawnetta Janene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Sep 4th, 2019 - about 5 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 1619958790 NPPES
Georgia Other 455887 WELLCARE
Georgia Other 800612 WELLCARE
Georgia MEDICAID 000572921 WELLCARE
Georgia Other 3557650 WELLCARE
Georgia Other 990009079 WELLCARE
Georgia Other 123000100 WELLCARE

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