1831264407 NPI number — WILLIAM E HOLCOMB MD & ASSOCIATES, INC.

Table of content: (NPI 1831264407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831264407 NPI number — WILLIAM E HOLCOMB MD & ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM E HOLCOMB MD & ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WILLIAM E HOLCOMB MD & ASSOCIATES, PC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831264407
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1813 KRESS STREET NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULLMAN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35058-1565
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-739-3605
Provider Business Mailing Address Fax Number:
256-734-8681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1813 KRESS STREET NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CULLMAN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35058-1565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-739-3605
Provider Business Practice Location Address Fax Number:
256-734-8681
Provider Enumeration Date:
11/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHEA
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
636-227-2600

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  S726 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 13470 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CK9309 . This is a "RAILROAD MEDICARE GROUP #" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: J244 . This is a "MEDICARE GROUP#" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".