Provider Demographics
NPI:1134107006
Name:HOLCOMB, BARRY WAYNE JR (MD,FCCP)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:WAYNE
Last Name:HOLCOMB
Suffix:JR
Gender:M
Credentials:MD,FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 THREE SPRINGS BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8296
Mailing Address - Country:US
Mailing Address - Phone:970-764-2750
Mailing Address - Fax:970-764-2778
Practice Address - Street 1:1010 THREE SPRINGS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8296
Practice Address - Country:US
Practice Address - Phone:970-764-2750
Practice Address - Fax:970-764-2778
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35273207RC0200X
CODR.0036438207RP1001X
CO36438207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO71036237Medicaid
CO71036237Medicaid
AZZ113105Medicare PIN
CO526698Medicare ID - Type Unspecified