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General NPI Number Information
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NPI Number | 1023534120
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Entity Type | Individual
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Provider Name | IAN HOLT PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 09/29/2020
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Provider Practice Location Address
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Address Line | 711 MARTIN LUTHER KING JR BLVD
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City | ASHLAND
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State | KY
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Zip | 41101-2668
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Country | US
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Telephone | 606-324-7119
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Fax |
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Provider Business Mailing Address
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Address Line | 14120 GRANT ST APT 16-302
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City | THORNTON
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State | CO
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Zip | 80023-6488
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Country | US
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Telephone | 304-575-1662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0010262
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 019490
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0023147
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License Number State | CO
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