Basic Information
| Provider Information | |||||||||
| NPI: | 1376768440 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLBERT | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 100256 | ||||||||
| Address2: | DEPARTMENT OF PSYCHIATRY | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326100256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522657981 | ||||||||
| FaxNumber: | 3522657983 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 SW ARCHER RD | ||||||||
| Address2: | UNIVERSITY OF FLORIDA | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326103003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522657981 | ||||||||
| FaxNumber: | 3522657983 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2007 | ||||||||
| LastUpdateDate: | 02/23/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084A0401X | ME117810 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | 207Q00000X | 69866 | GA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.