Provider Demographics
NPI:1417997016
Name:HOLFINGER, JAMES R (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:HOLFINGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-609-1112
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:7255 OLD OAK BLVD
Practice Address - Street 2:SUITE C308
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3329
Practice Address - Country:US
Practice Address - Phone:440-816-2735
Practice Address - Fax:440-816-5306
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001887213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000130235OtherANTHEM
OH2700355OtherUNITED HEALTHCARE
OH0380305Medicaid
OH104856OtherKAISER
OHP01887OtherSUMMA
OH00150011OtherMEDICAL MUTUAL
OH0454062Medicare ID - Type Unspecified
OHT80464Medicare UPIN