Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 59081 | LA |
Y | 111NI0900X | Internist | 59081 | LA |
N | 207RN0300X | Nephrologist | 015961 | LA |
N | 207RN0300X | Nephrologist | 059081 | GA |
NPI | 1013070424 |
---|---|
Provider Name | Eric Edward Holt I |
First Address | Mandeville, LA 70471-7432 |
Second Address | New Orleans, LA 70125-1743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 03/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1385069 | (05) | LA |
C33148 | (02) | GA |