Provider Demographics
NPI:1336353457
Name:DR B. E. HOLMES PA
Entity Type:Organization
Organization Name:DR B. E. HOLMES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:501-676-6560
Mailing Address - Street 1:305 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-3119
Mailing Address - Country:US
Mailing Address - Phone:501-676-6560
Mailing Address - Fax:501-676-7166
Practice Address - Street 1:305 W FRONT ST
Practice Address - Street 2:
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-3119
Practice Address - Country:US
Practice Address - Phone:501-676-6560
Practice Address - Fax:501-676-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC2033207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4979243001OtherCIGNA
AR4208778OtherAETNA
AR011704651OtherPALMETTO GBA-RAILROAD MED
AR111581002Medicaid
AR103250001Medicaid
AR61196OtherUNITEDHEALTHCARE
AR770014101OtherBREASTCARE
AR52440Medicare PIN
AR4979243001OtherCIGNA