Provider Demographics
NPI:1770357519
Name:DEMPSEY, HOLLAND
Entity type:Individual
Prefix:MS
First Name:HOLLAND
Middle Name:
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 AL HIGHWAY 14 E
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36703-3215
Mailing Address - Country:US
Mailing Address - Phone:334-874-8357
Mailing Address - Fax:334-874-7916
Practice Address - Street 1:1501 AL HIGHWAY 14 E
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36703-3215
Practice Address - Country:US
Practice Address - Phone:334-874-8357
Practice Address - Fax:334-874-7916
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2440003156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician