Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 19035 | AL |
Y | 207RP1001X | Pulmonary Disease | 19035 | AL |
N | 207RS0012X | Sleep Medicine | 19035 | AL |
NPI | 1013015254 |
---|---|
Provider Name | Dr. Edsel P Holden II |
First Address | Florence, AL 35630-5323 |
Second Address | Florence, AL 35630-5323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 12/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051507070 | (05) | AL |
F86167 | (02) | AL |
P00076769 | RAILROAD MEDICARE (01) | AL |