Healthcare Provider Details

I. General information

NPI: 1689670333
Provider Name (Legal Business Name): GEORGE F HOLMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BLAKE AVE
GLENWOOD SPGS CO
81601-4227
US

IV. Provider business mailing address

PO BOX 2725
GLENWOOD SPGS CO
81602-2725
US

V. Phone/Fax

Practice location:
  • Phone: 970-384-7607
  • Fax: 970-947-8811
Mailing address:
  • Phone: 970-945-1443
  • Fax: 970-947-9410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number44047
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: