Provider Demographics
NPI:1679571285
Name:HOLMES, CHRISTINE PHILLIPS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:PHILLIPS
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:PHILLIPS
Other - Last Name:MOHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6285 S HIGLEY RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-4262
Mailing Address - Country:US
Mailing Address - Phone:480-460-4949
Mailing Address - Fax:480-460-5858
Practice Address - Street 1:6285 S HIGLEY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-4262
Practice Address - Country:US
Practice Address - Phone:480-460-4949
Practice Address - Fax:480-460-5858
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24140208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0158780OtherBCBS
AZ5088685OtherAETNA