Individual
DR. BILLY HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1868 N DEFFER DR, NIXA, MO 65714-8438
(417) 595-7826
Mailing address
1868 N DEFFER DR, NIXA, MO 65714-8438
(417) 595-7826
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2006019876
MO
207Q00000X
Family Medicine Physician
2006019876
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659395960
—
MO
01
—
2006019876
STATE MEDICAL LICENSE
MO
01
—
P00679391
RR MEDICARE
MO
Enumeration date
07/27/2006
Last updated
07/08/2023
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