Provider Demographics
NPI:1174577431
Name:HOLKINS, JOHN MCGARRY (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MCGARRY
Last Name:HOLKINS
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 1:203 NW RD MIZE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014
Mailing Address - Country:US
Mailing Address - Phone:816-220-1117
Mailing Address - Fax:816-228-2053
Practice Address - Street 1:203 NW RD MIZE RD STE 200
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014
Practice Address - Country:US
Practice Address - Phone:816-220-1117
Practice Address - Fax:816-228-2053
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4B74207R00000X, 207RC0000X, 207RI0011X
KS0419088207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005755239OtherAETNA HMO
8966014OtherBLUE SHIELD OF KC PPO
0005755239OtherAETNA
060013887OtherMEDICARE RAILROAD
431092652A023OtherCHAMPUS TRICARE
8966014OtherBLUE SHIELD OF KC HMO
MO1174577431Medicaid
0005755239OtherAETNA PPO
8966014OtherPHP FREEDOM
MOP00853585OtherMEDICARE RAILROAD
060013887OtherMEDICARE RAILROAD
8966014OtherBLUE SHIELD OF KC HMO
431092652A023OtherCHAMPUS TRICARE
8966014OtherBLUE SHIELD OF KC PPO