Provider Demographics
NPI:1194851675
Name:HOLSOMBACK, JAMES STEVEN (RN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STEVEN
Last Name:HOLSOMBACK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:HOLSOMBACK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1316 SOMERVILLE RD SE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4305
Mailing Address - Country:US
Mailing Address - Phone:256-355-6091
Mailing Address - Fax:256-260-7337
Practice Address - Street 1:1316 SOMERVILLE RD SE
Practice Address - Street 2:SUITE 1
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4305
Practice Address - Country:US
Practice Address - Phone:256-355-6091
Practice Address - Fax:256-260-7337
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10845602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry