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General NPI Number Information
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NPI Number | 1508150988
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Entity Type | Individual
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Provider Name | RICHARD FRANK HOLT D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2011
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 107 E OAK AVE
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1818
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Country | US
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Telephone | 928-779-7880
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Fax | 928-779-7895
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Provider Business Mailing Address
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Address Line | 1200 N BEAVER ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3118
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Country | US
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Telephone | 928-213-6235
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Fax | 928-213-6292
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2012017428
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | DO-04907
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 006708
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License Number State | AZ
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