MEDICARE: DAVID BENJAMIN HOLT PA-C

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	363A00000X	Physician Assistant	PA-903	AR

General Provider Information

NPI Number	:	1912533589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BENJAMIN HOLT PA-C

Provider Business Mailing Address
First Line	:	116 RIVERVIEW DR
Second Line	:
City	:	MAUMELLE
State	:	AR
Zip	:	72113-5950
Country	:	US
Telephone Number	:	501-590-2720
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 LEXINGTON AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-4738
Country	:	US
Telephone Number	:	479-226-3132
Fax Number	:	479-226-3136

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

Provider Enumeration Date	:	03/16/2020
Last Update Date	:	03/12/2026

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