Provider Demographics
NPI:1417315896
Name:HOLDER, HUNTER J
Entity Type:Individual
Prefix:MR
First Name:HUNTER
Middle Name:J
Last Name:HOLDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 RIMROCK RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7252
Mailing Address - Country:US
Mailing Address - Phone:972-977-8473
Mailing Address - Fax:
Practice Address - Street 1:700 RIMROCK RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-7252
Practice Address - Country:US
Practice Address - Phone:972-977-8473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator