Holder, Kenneth L
Holder, Kenneth L is an sole proprietor health care provider with primary practice located at 264 Southwest Dr , Jonesboro AR 72401-5829. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Holder, Kenneth L can be contacted via phone (870) 336-2976.Contact Information
Primary practice address
264 Southwest Dr
Jonesboro AR 72401-5829
Phone: (870) 336-2976
Fax: (870) 931-0665
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | E-7966 | Arkansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E-7966 | Arkansas |
Profile Details
| NPI number | 1477659464 |
|---|---|
| LBN Legal business name | Holder, Kenneth L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Jul 27th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477659464 | NPPES |
| Kentucky | MEDICAID | 64320625 | |
| Kentucky | Other | 32062 | |
| Kentucky | Other | E-7966 | |
| Kentucky | Other | 000000044326 |
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