Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01065964A | IN |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 43170 | AZ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A95064 | CA |
N | 207YS0123X | Facial Plastic Surgeon | 01065964A | IN |
Y | 207YS0123X | Facial Plastic Surgeon | 43170 | AZ |
N | 207YS0123X | Facial Plastic Surgeon | A95064 | CA |
NPI | 1093986804 |
---|---|
Provider Name | Dr. Paul Kenneth Holden |
First Address | Scottsdale, AZ 85260-1680 |
Second Address | Scottsdale, AZ 85260-1680 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2008 |
Last Update Date | 05/10/2015 |