Provider Demographics
NPI:1801201678
Name:HOLMES, ROBIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:A
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3959 BEN WALTERS LN
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7707
Mailing Address - Country:US
Mailing Address - Phone:907-235-3436
Mailing Address - Fax:907-235-8346
Practice Address - Street 1:15765 KINGSLEY RD
Practice Address - Street 2:
Practice Address - City:NINILCHIK
Practice Address - State:AK
Practice Address - Zip Code:99639
Practice Address - Country:US
Practice Address - Phone:907-567-3970
Practice Address - Fax:907-567-3902
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2023-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK113124207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1613461Medicaid