Basic Information
| Provider Information | |||||||||
| NPI: | 1992868731 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLTZLANDER | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2472 BOLD VENTURE DR | ||||||||
| Address2: | |||||||||
| City: | LEWIS CENTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430359690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145702048 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2615 E HIGH ST | ||||||||
| Address2: | SPRINGFIELD COMMUNITY HOSPITAL | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 455051412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373250531 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 35083708 | OH | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.