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DR. CARROLL EUGENE HOLSTED MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1215195649

Individual Registrant:
DR. CARROLL EUGENE HOLSTED MD
Gender: M
Sole Proprietor

Location and contact information for practice:
3 WOODBRIDGE DR  BELLA VISTA, AR 72714-1927 US
Tel: 479-855-2160  Fax: 479-876-6312

Contact information for business:
3 WOODBRIDGE DR  BELLA VISTA, AR 72714-1927 US
Tel: 479-855-2160  Fax: 479-876-6312

Registration Information:
NPI: 1215195649
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
OK8959

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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