| Holloway Internal Medicine | |
|
415 E 4th Ave Ste B Cordele GA 31015-0614 | |
| (229) 276-2190 | |
| (229) 276-3639 |
| Full Name | Holloway Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 415 E 4th Ave Ste B, Cordele, Georgia |
| Authorized Official Name and Position | Kevin M Holloway (ORGANIZER) |
| Authorized Official Contact | 2292762190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holloway Internal Medicine 1801 Quail Run Cordele GA 31015-2096 | Holloway Internal Medicine 415 E 4th Ave Ste B Cordele GA 31015-0614 Ph: (229) 276-2190 |
| NPI Number | 1023908977 |
|---|---|
| Provider Enumeration Date | 07/03/2025 |
| Last Update Date | 07/14/2025 |
| Certification Date | 07/14/2025 |
| Medicare PECOS PAC ID | 0840788303 |
|---|---|
| Medicare Enrollment ID | O20251024003160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023908977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Kevin M Holloway |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114107810 PECOS PAC ID: 2860563962 Enrollment ID: I20080617000741 |
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