Healthcare Provider Details

I. General information

NPI: 1467652750
Provider Name (Legal Business Name): HOLMES MEDICAL SERVICES PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1908 N 14TH ST SUITE 202
PONCA CITY OK
74601-2014
US

IV. Provider business mailing address

1908 N 14TH ST SUITE 202
PONCA CITY OK
74601-2014
US

V. Phone/Fax

Practice location:
  • Phone: 580-767-1777
  • Fax: 580-762-2917
Mailing address:
  • Phone: 580-767-1777
  • Fax: 580-762-2917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4196
License Number StateOK

VIII. Authorized Official

Name: DEREK R HOLMES
Title or Position: OWNER
Credential: DO
Phone: 580-767-1777