| Jerry M Holley Md Pllc | |
|
4100 Austin Peay Hwy Memphis TN 38128-2502 | |
| (901) 486-1151 | |
| (901) 844-1439 |
| Full Name | Jerry M Holley Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4100 Austin Peay Hwy, Memphis, Tennessee |
| Authorized Official Name and Position | Jerry M Holley (OWNER) |
| Authorized Official Contact | 9014861151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry M Holley Md Pllc 8131 Rebecca Woods Dr Arlington TN 38002-5798 Ph: (901) 486-1151 | Jerry M Holley Md Pllc 4100 Austin Peay Hwy Memphis TN 38128-2502 Ph: (901) 486-1151 |
| NPI Number | 1013400852 |
|---|---|
| Provider Enumeration Date | 06/06/2018 |
| Last Update Date | 11/12/2018 |
| Medicare PECOS PAC ID | 6507118304 |
|---|---|
| Medicare Enrollment ID | O20181005000807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013400852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 020391 (Tennessee) | Primary |
| Provider Name | Jerry Morgan Holley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851494462 PECOS PAC ID: 0547386534 Enrollment ID: I20100928000244 |
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