Provider Demographics
NPI:1023042595
Name:HOLMAN, CAROL JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:JOY
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1007
Mailing Address - Country:US
Mailing Address - Phone:319-356-3981
Mailing Address - Fax:319-384-8051
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1007
Practice Address - Country:US
Practice Address - Phone:319-356-3981
Practice Address - Fax:319-384-8051
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46208207ZH0000X, 207ZP0102X
IA39511207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN11-00506OtherMEDICA CHOICE
MT0145078Medicaid
MN11-00014OtherMEDICA PRIMARY
IA0596528Medicaid
MN243679500Medicaid
MNHP53866OtherHEALTHPARTNERS
MN1044939OtherPREFERRED ONE
MN135109OtherUCARE
MN2372495OtherARAZ
MN503K4HOOtherBCBS
MNI33755Medicare UPIN
MN503K4HOOtherBCBS
MN243679500Medicaid
MN135109OtherUCARE