Basic Information
| Provider Information | |||||||||
| NPI: | 1043299464 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOLLIS | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | DIXON | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 20TH AVE N | ||||||||
| Address2: | STE 403 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372035180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152844088 | ||||||||
| FaxNumber: | 6152847501 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 STEAM PLANT RD | ||||||||
| Address2: | STE. 470 | ||||||||
| City: | GALLATIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370663032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154517706 | ||||||||
| FaxNumber: | 6154517708 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 07/23/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 38253 | TN | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 174400000X | 38253 | TN | N | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | I7522 | 01 | TN | HEALTHSPRING | OTHER | 953233 | 01 | TN | USA MANAGED CARE | OTHER | 2241512 | 01 | TN | FIRST HEALTH | OTHER | 4087130 | 01 | TN | BCBS | OTHER | 7824568 | 01 | TN | AETNA | OTHER | 9466849 | 01 | TN | CIGNA | OTHER |