Dr Jacob Harvey Holley Iii, MD is a medicare enrolled "General Practice" physician in Donalsonville, Georgia. He went to Medical College Of Georgia School Of Medicine and graduated in 2013 and has 12 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Southwest Georgia Healthcare Clinics, Inc. and his current practice location is
214 Cherry St, Donalsonville, Georgia. You can reach out to his office (for appointments etc.) via phone at
(229) 524-2232.
Dr Jacob Harvey Holley Iii is licensed to practice in Georgia (license number 81053) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1962842013.
Physician's Profile
| Full Name | Dr Jacob Harvey Holley Iii |
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| Gender | Male |
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| Speciality | General Surgery |
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| Experience | 12 Years |
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| Location | 214 Cherry St, Donalsonville, Georgia |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Jacob Harvey Holley Iii attended and graduated from Medical College Of Georgia School Of Medicine in 2013
NPI Data:
- NPI Number: 1962842013
- Provider Enumeration Date: 07/02/2013
- Last Update Date: 01/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 6901032085
- Enrollment ID: I20181022001718
Medical Identifiers
Medical identifiers for Dr Jacob Harvey Holley Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1962842013 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208600000X | Surgery | 36063 (South Carolina) | Secondary |
| 208D00000X | General Practice | 81053 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southwest Georgia Healthcare Clinics, Inc. | 9739457896 | 7 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jacob Harvey Holley Iii allows following entities to bill medicare on his behalf.
| Entity Name | Donalsonville Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720095805
PECOS PAC ID: 7113919820
Enrollment ID: O20040401001194 |
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| Entity Name | Jeffrey N Holley Md Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770620098
PECOS PAC ID: 9739142092
Enrollment ID: O20041108000630 |
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| Entity Name | Southwest Georgia Healthcare Clinics, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881867000
PECOS PAC ID: 9739457896
Enrollment ID: O20170613002024 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jacob Harvey Holley Iii is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Jacob Harvey Holley Iii, MD
101 E Wood St,
Spartanburg, SC 29303-3040
Ph: (229) 254-1857 | Dr Jacob Harvey Holley Iii, MD
214 Cherry St,
Donalsonville, GA 39845-1616
Ph: (229) 524-2232 |
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