Provider Demographics
NPI:1174795785
Name:HOLLAND CENTER FOR FAMILY MEDICINE LTD
Entity type:Organization
Organization Name:HOLLAND CENTER FOR FAMILY MEDICINE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-978-8477
Mailing Address - Street 1:6760 W. THUNDERBIRD RD.
Mailing Address - Street 2:SUITE E-100
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381
Mailing Address - Country:US
Mailing Address - Phone:602-978-8477
Mailing Address - Fax:602-978-0734
Practice Address - Street 1:6760 W. THUNDERBIRD RD.
Practice Address - Street 2:SUITE E-100
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381
Practice Address - Country:US
Practice Address - Phone:602-978-8477
Practice Address - Fax:602-978-0734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17551207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty