Provider Demographics
NPI:1275972051
Name:OBHOLZ, JOSHUA JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:JAMES
Last Name:OBHOLZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 J ST BLDG 109
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS AFB
Mailing Address - State:ND
Mailing Address - Zip Code:58205-6306
Mailing Address - Country:US
Mailing Address - Phone:701-747-5560
Mailing Address - Fax:
Practice Address - Street 1:1005 N EASTMAN RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-4231
Practice Address - Country:US
Practice Address - Phone:903-247-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine