Individual
MICKEL A HOLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
207 DAVENPORT, MER ROUGE, LA 71261
(318) 647-3412
Mailing address
PO BOX 4522, MONROE, LA 71211-4522
(318) 518-8499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200114
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA.200114
LICENSE NUMBER
LA
Enumeration date
11/24/2006
Last updated
02/29/2012
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