Holley, Keith G

Holley, Keith G is an individual health care provider with primary practice located at 4424 E Flamingo Ave Suite 110, Nampa ID 83687. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery, which is considered as his primary health care specialty. Holley, Keith G can be contacted via phone (208) 288-4700.

Contact Information

Primary practice address
4424 E Flamingo Ave Suite 110 Nampa ID 83687
Phone: (208) 288-4700
Fax: (208) 288-4720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery 207XS0114X MD00045579 Washington
Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery 207XS0114X M-11367 Idaho

Profile Details

NPI number 1386616183
LBN Legal business name Holley, Keith G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Oct 22nd, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386616183 NPPES
Idaho MEDICAID 1386616183

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