Provider Demographics
NPI:1427051275
Name:HOLETS, JOHN ALAN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ALAN
Last Name:HOLETS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-2564
Mailing Address - Country:US
Mailing Address - Phone:724-258-2070
Mailing Address - Fax:724-258-3582
Practice Address - Street 1:447 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2564
Practice Address - Country:US
Practice Address - Phone:724-258-2070
Practice Address - Fax:724-258-3582
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029310E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0C32563OtherHEALTH AMERICA
PA215987OtherUPMC
PA66094OtherUNISON
PA1427051275OtherNPI
PA53861OtherUNITEDHEALTHCARE
PA0075063OtherAETNA
PA0010553800002Medicaid
PA0C32563OtherHEALTH ASSURANCE
PA165390Medicare ID - Type Unspecified
PA0010553800002Medicaid