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Individual

DR. JEFFREY EDWARDS HOLMBERG

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
360 AMSDEN AVE, VERSAILLES, KY 40383-1851
(859) 873-3111
Mailing address
4868 WATERSIDE DR, LEXINGTON, KY 40513-1415

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
23686
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64236862
KY
Enumeration date
06/10/2006
Last updated
07/09/2007
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