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General NPI Number Information
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NPI Number | 1669656609
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Entity Type | Organization
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Legal Business Name | ROBERT B HOLDER, LLC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 174 S CORONADO DR SUITE A
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City | SIERRA VISTA
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State | AZ
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Zip | 85635
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Country | US
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Telephone | 520-417-9920
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Fax | 520-417-9919
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Provider Business Mailing Address
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Address Line | 2818 E EAGLE ROCK DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85650-8584
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Country | US
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Telephone | 520-378-4619
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT B HOLDER
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Credential | M.D.
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Telephone | 520-417-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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