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General NPI Number Information
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NPI Number | 1225130388
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Entity Type | Organization
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Legal Business Name | MICHAEL E. HOLTON, M.D., PC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 530 S MAIN ST
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City | CHURUBUSCO
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State | IN
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Zip | 46723-2220
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Country | US
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Telephone | 260-693-9888
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Fax | 260-693-1677
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Provider Business Mailing Address
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Address Line | 530 S MAIN ST
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City | CHURUBUSCO
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State | IN
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Zip | 46723-2220
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Country | US
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Telephone | 260-693-9888
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Fax | 260-693-1677
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JUDY HOLTON
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Credential |
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Telephone | 260-693-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01038768
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License Number State | IN
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