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Individual

DR. JEFFREY WAYNE HOLT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1503 MAIN ST, DES ARC, AR 72040-3299
(870) 256-4178
(870) 256-4085
Mailing address
PO BOX 497, AUGUSTA, AR 72006-0497
(870) 347-2534
(870) 347-1235

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E13027
AR
207R00000X
Internal Medicine Physician
Primary
E-13027
AR
207RC0000X
Cardiovascular Disease Physician
E-13027
AR
207RC0000X
Cardiovascular Disease Physician
MD.12690R
LA
207RI0011X
Interventional Cardiology Physician
MD.12690R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
204499001
AR
01
P00755804
RAILROAD MEDICARE
LA
Enumeration date
08/09/2006
Last updated
06/28/2022
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