Provider Demographics
NPI:1073526273
Name:HOLMAN, WILLIAM M (OD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:HOLMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 E 9TH
Mailing Address - Street 2:WINFIELD FAMILY OPTOMETRY
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-3441
Mailing Address - Country:US
Mailing Address - Phone:620-221-2015
Mailing Address - Fax:620-221-2466
Practice Address - Street 1:3000 E 9TH
Practice Address - Street 2:STE B
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156
Practice Address - Country:US
Practice Address - Phone:620-221-2015
Practice Address - Fax:620-221-2466
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS1376152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100219810BMedicaid
U34737Medicare UPIN
043180Medicare ID - Type Unspecified