Provider Demographics
NPI:1619029899
Name:REPUBLIC COUNTY FAMILY PHYSICIANS, CHTD.
Entity Type:Organization
Organization Name:REPUBLIC COUNTY FAMILY PHYSICIANS, CHTD.
Other - Org Name:ROBERT E. HOLT, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-527-2237
Mailing Address - Street 1:2337 G ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BELLEVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66935-2463
Mailing Address - Country:US
Mailing Address - Phone:785-527-2237
Mailing Address - Fax:785-527-2820
Practice Address - Street 1:2337 G ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BELLEVILLE
Practice Address - State:KS
Practice Address - Zip Code:66935-2463
Practice Address - Country:US
Practice Address - Phone:785-527-2237
Practice Address - Fax:785-527-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17247207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty