Provider Demographics
NPI:1124025267
Name:HOLCOMB, JOHN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:HOLCOMB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S SCHOOL AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-6045
Mailing Address - Country:US
Mailing Address - Phone:941-365-8679
Mailing Address - Fax:941-365-8680
Practice Address - Street 1:1 S SCHOOL AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6045
Practice Address - Country:US
Practice Address - Phone:941-365-8679
Practice Address - Fax:941-365-8680
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80017207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME80017OtherFLORIDA MEDICAL LICENSE
FLME80017OtherFLORIDA MEDICAL LICENSE
F62615Medicare UPIN