Provider Demographics
NPI:1174504179
Name:HOLMAN, SHERRIE ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERRIE
Middle Name:ELIZABETH
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 DECATUR PIKE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-2470
Mailing Address - Country:US
Mailing Address - Phone:423-744-3938
Mailing Address - Fax:423-745-6565
Practice Address - Street 1:1450 DECATUR PIKE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-2470
Practice Address - Country:US
Practice Address - Phone:423-744-3938
Practice Address - Fax:423-745-6565
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1361152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4086615OtherBCBS #
TN4086615OtherBCBS #
TNMH1075933OtherDEA #
TN3598586Medicare ID - Type UnspecifiedMEDICARE NUMBER
TN5288520001Medicare NSC
TN4086615OtherBCBS #
TNU38244Medicare UPIN