MEDICARE: JOHN M. HOLDER DO

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	207Q00000X	Family Medicine Physician	AZ1437	AZ

General Provider Information

NPI Number	:	1245368794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN M. HOLDER DO

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	602-866-8603
Fax Number	:	602-866-2413

Provider Business Practice Location Address
First Line	:	720 E THUNDERBIRD RD
Second Line	:	STE 3
City	:	PHOENIX
State	:	AZ
Zip	:	85022-5396
Country	:	US
Telephone Number	:	602-866-8603
Fax Number	:	602-866-2413

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

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	09/21/2016

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Directions to “ JOHN M. HOLDER DO” Practice Location

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