DR. BRIAN A HOLTAN (NPI# 1265469399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265469399 |
| Entity Type | Individual |
| Full Name | DR. BRIAN A HOLTAN |
| Credential | MD |
| Practice Address |
31003 N 118th Ln Peoria AZ 85383-8240 |
| Practice Telephone | 6232426958 |
| Mailing Telephone | 6232426958 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2016-07-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
36220 | AZ | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
3921A | WY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | TRIWEST UINTA | 83022243882935A002 | 01 |
| UT | 1265469399 | 05 | |
| AZ | 179931 | 05 | |
| WY | 103629700 | 05 | |
| WY | BCBS OF WY | 305941 | 01 |
| WY | TRIWEST COLLEGE | 83022243882901A002 | 01 |
| Street Address |
31003 N 118TH LN |
| City | PEORIA |
| State | AZ |
| Zip Code | 85383-8240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831701218 | West Point Optical Group | Optometrist | 24775 N. Pleasant Pkwy, Peoria, AZ 85383 | 2020-08-18 |
| 1528694247 | Lake Pleasant Kids Dentists and Orthodontics, LLP | Dentist | 24775 North Lake Pleasant Parkway Suite 104, Peoria, AZ 85383 | 2020-03-13 |
| 1124502273 | Nicole Angelina Hennigan | Registered Nurse | 9710 W. Happy Valley Rd, Suite 100 (salon 16), Peoria, AZ 85383 | 2018-09-24 |
| 1962994012 | Reach for The Stars Pediatric Therapy Pllc | Physical Therapy Assistant | 8662 W Lariat Ln, Peoria, AZ 85383 | 2018-06-05 |
| 1013417617 | Elite Infusions LLC | Internal Medicine | 10252 W Villa Chula, Peoria, AZ 85383 | 2018-02-20 |
| 1427577238 | Serene Valley Care LLC | Assisted Living Facility | 29751 N 119th Lane, Peoria, AZ 85383 | 2017-09-12 |
| 1255857827 | Advanced Air Amulance LLC | Ambulance | 9463 West El Cortez Place, Peoria, AZ 85383 | 2017-08-16 |
| 1427578996 | Paul R Arthur | Physical Therapist | 9745 W. Happy Valley Rd, Peoria, AZ 85383 | 2017-06-26 |
| 1528597143 | Lucy Denton | Specialist/Technologist | 9234 West Andrea Drive, Peoria, AZ 85383 | 2017-06-07 |
| 1801263579 | John Leano | Pharmacist | 26898 N 87th Dr, Peoria, AZ 85383 | 2015-08-28 |
| Find all providers in zip 85383 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1932490075 | Christine Ann Wigginton | Radiology | 221 Ne Glen Oak Ave Dept Of, Peoria, IL 61636 | 2011-04-24 |
| 1932421591 | Smi Imaging, LLC | Radiology | 9125 W Thunderbird Rd, Suite 105, Peoria, AZ 85381-4920 | 2010-02-24 |
| 1972736163 | Smi Imaging, LLC | Radiology | 9403 W Thunderbird Rd, Peoria, AZ 85381-4825 | 2009-09-03 |
| 1184828360 | Jane Ho Maksimovic | Radiology | 2612 W Newman Pkwy, Peoria, IL 61604-2208 | 2007-06-12 |
| 1124030705 | Terry M Brady | Radiology | 411 Hamilton Blvd, 1824, Peoria, IL 61602-1144 | 2006-08-12 |
| 1275543456 | Kim V. Arellano-villarreal | Radiology | 401 Sw Water St, Peoria, IL 61602-1571 | 2006-08-09 |
| 1386659241 | Central Illinois Radiological Associates, Ltd. | Radiology | Osf St Francis Medical Ctr, 530 N.e. Glen Oak, Peoria, IL 61636-0001 | 2006-07-29 |
| 1538192828 | Central Illinois Radiological Associates, Ltd. | Radiology | 530 Ne Glen Oak Avenue, Peoria, IL 61637 | 2006-07-09 |
| 1992755870 | Jan Namyslowski | Radiology | 114 W Stratford Dr Ste E, Peoria, IL 61614-7300 | 2006-05-11 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.