Dr. Jeremy Patrick Holter
Internist Pediatrician
3315 Kethley Rd
Shawnee
, Oklahoma 74804-9638
Dr. Jeremy Patrick Holter
Internist Pediatrician
3315 Kethley Rd
Shawnee
, Oklahoma 74804-9638
(405) 878-3814
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About
Features
Specialties
- Internist
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Jeremy Patrick Holter
- Po Box 849
- Shawnee, OK
- Zip : 74802-0849
- Fax : (405) 878-3814
- Phone : (405) 273-5801
Second Address
- Dr. Jeremy Patrick Holter
- 3315 Kethley Rd
- Shawnee, OK
- Zip : 74804-9638
- Fax : (405) 878-3814
- Phone : (405) 273-5801
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | 22964 | OK |
| Y | 111NI0900X | Internist | 22964 | OK |
| N | 208000000X | Pediatrician | 22964 | OK |
National Provider Identifier
| NPI | 1003859778 |
|---|---|
| Provider Name | Dr. Jeremy Patrick Holter |
| First Address | Shawnee, OK 74802-0849 |
| Second Address | Shawnee, OK 74804-9638 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/06/2006 |
| Last Update Date | 30/08/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200057970A | (05) | OK |
| I41106 | (02) | OK |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.