Provider Demographics
NPI:1467652750
Name:HOLMES MEDICAL SERVICES PLC
Entity Type:Organization
Organization Name:HOLMES MEDICAL SERVICES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:580-767-1777
Mailing Address - Street 1:1908 N 14TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-2014
Mailing Address - Country:US
Mailing Address - Phone:580-767-1777
Mailing Address - Fax:580-762-2917
Practice Address - Street 1:1908 N 14TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-2014
Practice Address - Country:US
Practice Address - Phone:580-767-1777
Practice Address - Fax:580-762-2917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4196207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200118420AMedicaid
OK=========001OtherBLUE CROSS BLUE SHIELD
OK500522212Medicare PIN
OK200118420AMedicaid