Provider Demographics
NPI:1063730232
Name:DAVID A. HOLMES, M.A., P.C.
Entity type:Organization
Organization Name:DAVID A. HOLMES, M.A., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:928-778-5132
Mailing Address - Street 1:1125 W IRON SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-1623
Mailing Address - Country:US
Mailing Address - Phone:928-778-5132
Mailing Address - Fax:928-778-3005
Practice Address - Street 1:1125 W IRON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1623
Practice Address - Country:US
Practice Address - Phone:928-778-5132
Practice Address - Fax:928-778-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA513237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1053466714OtherINDIVIDUAL NPI
AZ1053466714OtherINDIVIDUAL NPI
AZZ125465Medicare PIN