Healthcare Provider Details

I. General information

NPI: 1891945812
Provider Name (Legal Business Name): AMY HOLMES MEDICAL SERVICES PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E CHEROKEE
MEDFORD OK
73759-1210
US

IV. Provider business mailing address

102 E CHEROKEE
MEDFORD OK
73759-1210
US

V. Phone/Fax

Practice location:
  • Phone: 580-395-2800
  • Fax: 580-395-2099
Mailing address:
  • Phone: 580-395-2800
  • Fax: 580-395-2099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMY NICOLE HOLMES
Title or Position: OWNER
Credential: MD
Phone: 580-395-2800