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NPI Code Detail

MEDICARE: KATHERINE HOLMES MD

MEDICARE: KATHERINE HOLMES MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician262768NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1262768OTHERNYLICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3226314OTHERMAMEDICAL LICENSE

General Provider Information

NPI Number : 1205823705
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE HOLMES MD
Provider Business Mailing Address
First Line : 346 GRAND AVE
Second Line :
City : JOHNSON CITY
State : NY
Zip : 13790-2580
Country : US
Telephone Number : 607-763-6075
Fax Number : 607-763-5234
Provider Business Practice Location Address
First Line : 40 ARCH ST
Second Line :
City : JOHNSON CITY
State : NY
Zip : 13790-2102
Country : US
Telephone Number : 607-763-6075
Fax Number : 607-763-5234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 02/09/2015

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Directions to “ KATHERINE HOLMES MD” Practice Location

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