Dr Larry Holmes, PHD is a medicare enrolled "Psychologist" provider in Arbor Vitae, Wisconsin. His current practice location is
11102 Tuckaway Rd, Arbor Vitae, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 358-5400.
Dr Larry Holmes is licensed to practice in Wisconsin (license number 2535) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1558472183.
Healthcare Provider's Profile
| Full Name | Dr Larry Holmes |
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| Gender | Male |
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| Speciality | Psychologist |
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| Location | 11102 Tuckaway Rd, Arbor Vitae, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1558472183
- Provider Enumeration Date: 08/31/2006
- Last Update Date: 12/22/2010
Medicare PECOS Information:
- PECOS PAC ID: 0244273449
- Enrollment ID: I20050608000823
Medical Identifiers
Medical identifiers for Dr Larry Holmes such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558472183 | NPI | - | NPPES |
| WI1253 | Other | WI | MEDICARE PTAN |
| 39148300 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 2535 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Larry Holmes is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Larry Holmes, PHD
Po Box 1309,
Arbor Vitae, WI 54568-1309
Ph: (715) 358-5400 | Dr Larry Holmes, PHD
11102 Tuckaway Rd,
Arbor Vitae, WI 54568-8913
Ph: (715) 358-5400 |
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