| Dwight Holden, Md | |
|
3 East Golden Eagle Rd. Santa Fe NM 87506-8223 | |
| (505) 988-7476 | |
| (505) 986-6453 |
| Full Name | Dwight Holden, Md |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3 East Golden Eagle Rd., Santa Fe, New Mexico |
| Authorized Official Name and Position | Larry Dwight Holden (OWNER) |
| Authorized Official Contact | 5059887476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dwight Holden, Md 3 East Golden Eagle Rd. Santa Fe NM 87506-8223 Ph: (505) 988-7476 | Dwight Holden, Md 3 East Golden Eagle Rd. Santa Fe NM 87506-8223 Ph: (505) 988-7476 |
| NPI Number | 1427163807 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 07/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427163807 | NPI | - | NPPES |
| 10047270A | Medicaid | OK | MEDICAID PROVIDER ID |
| 1033133384 | Other | NPI INDIVIDUAL PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 16440 (Oklahoma) | Primary |
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