# HOLLY SPRINGS FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346353869
- **Authorized official:** RANDALL S KEITH MD (MEDICAL DOCTOR)
- **Authorized official phone:** (336) 786-7966

## Contact information

- **Practice address:** 104 ARARAT LONG HILL RD, PILOT MOUNTAIN, NC 27041-8113
- **Practice address phone:** (336) 786-7966
- **Practice address fax:** (336) 786-1601
- **Mailing address:** 104 ARARAT LONG HILL RD, PILOT MOUNTAIN, NC 27041-8113
- **Mailing address phone:** (336) 786-7966
- **Mailing address fax:** (336) 786-1601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/17/2006
- **Last updated:** 06/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8948063 | — | NC |