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General NPI Number Information
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NPI Number | 1912009861
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Entity Type | Individual
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Provider Name | JASON GRANT HOLMAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | UNIVERSITY OF MISSOURI HOSPITAL 1 HOSPITAL DR DC032.00
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City | COLUMBIA
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State | MO
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Zip | 65212-5822
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Country | US
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Telephone | 573-882-2100
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Fax | 573-884-6109
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Provider Business Mailing Address
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Address Line | UNIVERSITY OF MISSOURI HOSPITAL 1 HOSPITAL DR DC032.00
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City | COLUMBIA
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State | MO
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Zip | 65212-0001
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Country | US
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Telephone | 573-882-2100
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Fax | 573-884-6109
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | N0102
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | T2004016534
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N0102
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 2020019644
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License Number State | MO
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