Provider Demographics
NPI:1164629911
Name:HOLLCROFT, JAMES WESLEY (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WESLEY
Last Name:HOLLCROFT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2143 E LAMAR RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-1147
Mailing Address - Country:US
Mailing Address - Phone:602-708-8753
Mailing Address - Fax:
Practice Address - Street 1:4100 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-8843
Practice Address - Country:US
Practice Address - Phone:602-737-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3799207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine