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General NPI Number Information
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NPI Number | 1134775984
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Entity Type | Individual
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Provider Name | KEVIN WILLIAM HOLTZMAN PHARM.D., RPH
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Gender | Male
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 1639 BRADLEY PARK DR STE 600
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City | COLUMBUS
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State | GA
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Zip | 31904-3625
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Country | US
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Telephone | 706-571-3426
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Fax |
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Provider Business Mailing Address
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Address Line | 8272 DREAM BOAT DR UNIT 1128
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City | COLUMBUS
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State | GA
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Zip | 31909-2571
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Country | US
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Telephone |
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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 | RPH031600
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License Number State | GA
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