Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 0401005495 | VA |
Y | 213EG0000X | General Practice | 0401005495 | VA |
NPI | 1003920281 |
---|---|
Provider Name | Dr. Joseph Charles Holmes JR. |
First Address | Dublin, VA 24084-0921 |
Second Address | Dublin, VA 24084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |