Individual
BENJAMIN HOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12142 S YUKON AVENUE, GLENPOOL, OK 74033-6621
(918) 935-3636
(918) 777-9019
Mailing address
12142 S YUKON AVENUE, GLENPOOL, OK 74033-6621
(918) 935-3636
(918) 777-9019
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
52911
KY
207P00000X
Emergency Medicine Physician
R4433
KY
207Q00000X
Family Medicine Physician
Primary
38874
OK
Other
Enumeration date
06/07/2017
Last updated
04/15/2024
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