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Individual

ERIC S VONHOLTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3202 MCINTOSH CIR STE 201, JOPLIN, MO 64804-3686
(417) 347-8560
(417) 347-8564
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-8560
(417) 347-8564

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
045655
GA
207R00000X
Internal Medicine Physician
Primary
2010001787
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000789874H
GA
Enumeration date
07/24/2006
Last updated
02/16/2011
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