Provider Demographics
NPI:1326047606
Name:HOLDEN, NORMAN BROOKS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:BROOKS
Last Name:HOLDEN
Suffix:JR
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 1:214 BUSH RIVER DR
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901
Mailing Address - Country:US
Mailing Address - Phone:434-392-3187
Mailing Address - Fax:434-392-5789
Practice Address - Street 1:214 BUSH RIVER DR
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901
Practice Address - Country:US
Practice Address - Phone:434-392-3187
Practice Address - Fax:434-392-5789
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2013-09-10
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
VA01010277612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA260000119Medicare PIN