Provider Demographics
NPI:1487911939
Name:HOLMAN CLINIC PA
Entity type:Organization
Organization Name:HOLMAN CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:850-432-9023
Mailing Address - Street 1:14 W JORDAN ST
Mailing Address - Street 2:SUITE 1J
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-1736
Mailing Address - Country:US
Mailing Address - Phone:850-432-9023
Mailing Address - Fax:850-432-4814
Practice Address - Street 1:14 W JORDAN ST
Practice Address - Street 2:SUITE 1J
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1736
Practice Address - Country:US
Practice Address - Phone:850-432-9023
Practice Address - Fax:850-432-4814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME058640261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service