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Organization

CRAIG D HOLMAN CHARTERED

Active
Other names
Magic Valley Foot & Ankle Specialist
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CRAIG D HOLMAN DPM (OWNER)
(208) 734-7676
Entity
Organization

Contact information

Practice address
496 SHOUP AVE W # B, TWIN FALLS, ID 83301-5043
(208) 734-7676
(208) 736-8378
Mailing address
496 SHOUP AVE W # B, TWIN FALLS, ID 83301-5043
(208) 734-7676
(208) 736-8378

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P119
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010152611
REGENCE BLUE SHIELD OF ID
ID
01
185440600
US DEPT OF LABOR
ID
01
4134570001
DMERC
ID
01
480031477
RAILROAD MEDICARE
ID
01
P9343
BLUE CROSS OF IDAHO
ID
Enumeration date
05/21/2007
Last updated
06/21/2018
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