Provider Demographics
NPI:1548264070
Name:HOLMAN, RICHARD SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SCOTT
Last Name:HOLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:114 E SOUTH HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64468-2659
Mailing Address - Country:US
Mailing Address - Phone:660-562-2525
Mailing Address - Fax:660-562-4303
Practice Address - Street 1:2016 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-2655
Practice Address - Country:US
Practice Address - Phone:660-562-2525
Practice Address - Fax:660-562-7993
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2013-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO106093207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1930438Medicaid
MO247635113Medicaid
MOF85814Medicare UPIN
MOE265941Medicare Oscar/Certification