Basic Information
| Provider Information | |||||||||
| NPI: | 1881772804 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HENRY E HOLETS MD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 28 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242283418 | ||||||||
| FaxNumber: | 7242287040 | ||||||||
| Practice Location | |||||||||
| Address1: | 1290 CHESS ST | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | MONONGAHELA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242587500 | ||||||||
| FaxNumber: | 7242583618 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HOLETS | ||||||||
| AuthorizedOfficialFirstName: | HENRY | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7242587500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.