Holter, Jeremy Patrick

Holter, Jeremy Patrick is an individual health care provider with primary practice located at 3315 Kethley Rd , Shawnee OK 74804-9638. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Holter, Jeremy Patrick can be contacted via phone (405) 273-5801.

Contact Information

Primary practice address
3315 Kethley Rd Shawnee OK 74804-9638
Phone: (405) 273-5801
Fax: (405) 878-3814
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 22964 Oklahoma
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 22964 Oklahoma

Profile Details

NPI number 1003859778
LBN Legal business name Holter, Jeremy Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Aug 30th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003859778 NPPES
Oklahoma MEDICAID 200057970A

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