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Individual

DR. BRADLEY WYATT HOLT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6320 N LA CHOLLA BLVD STE 200, TUCSON, AZ 85741-3549
(520) 382-8200
(520) 297-3505
Mailing address
PO BOX 31630, TUCSON, AZ 85751-1630
(520) 784-6320
(520) 297-3505

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
R70503
AZ
208VP0014X
Interventional Pain Medicine Physician
Primary
42850
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
523022
AZ
Enumeration date
08/17/2009
Last updated
08/03/2020
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