MEDICARE: DR. DAVID ALLEN HOLMES AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	DA513	AZ

General Provider Information

NPI Number	:	1053466714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALLEN HOLMES AU.D.

Provider Business Mailing Address
First Line	:	1125 W IRON SPRINGS RD
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86305-1623
Country	:	US
Telephone Number	:	928-778-5132
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 W IRON SPRINGS RD
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86305-1623
Country	:	US
Telephone Number	:	928-778-5132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	05/05/2010

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