Healthcare Provider Details

I. General information

NPI: 1174577431
Provider Name (Legal Business Name): JOHN MCGARRY HOLKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW R D MIZE RD
BLUE SPRINGS MO
64014-2513
US

IV. Provider business mailing address

203 NW RD MIZE RD STE 200
BLUE SPRINGS MO
64014
US

V. Phone/Fax

Practice location:
  • Phone: 816-220-1117
  • Fax: 816-228-2053
Mailing address:
  • Phone: 816-220-1117
  • Fax: 816-228-2053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR4B74
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberR4B74
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0419088
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberR4B74
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: