Holloway, Jodie Susan
Holloway, Jodie Susan is an sole proprietor health care provider with primary practice located at 112 Random Oaks Ln , Mandeville LA 70448-4565. She recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as her primary health care specialty. Holloway, Jodie Susan can be contacted via phone (985) 674-0988.Contact Information
Primary practice address
112 Random Oaks Ln
Mandeville LA 70448-4565
Phone: (985) 674-0988
Fax: (985) 674-5308
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Legal Medicine | 173000000X | 019557 | Louisiana |
Profile Details
| NPI number | 1992921688 |
|---|---|
| LBN Legal business name | Holloway, Jodie Susan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 18th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992921688 | NPPES |
| Louisiana | MEDICAID | 1932744 |
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