Provider Demographics
NPI:1942274527
Name:HOLLAND, ROGER P (M D)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:P
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:217 RIDGETOP DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-1691
Mailing Address - Country:US
Mailing Address - Phone:830-290-4200
Mailing Address - Fax:706-771-4858
Practice Address - Street 1:3405 MIKE PADGETT HWY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-3815
Practice Address - Country:US
Practice Address - Phone:918-567-7000
Practice Address - Fax:706-771-4858
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2025-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH5900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX21H5900Medicaid
TX21H5900Medicaid