Provider Demographics
NPI:1235551359
Name:HOLCOMB-KREITHEN PLASTIC SURGERY & MEDSPA, PLLC
Entity Type:Organization
Organization Name:HOLCOMB-KREITHEN PLASTIC SURGERY & MEDSPA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-365-8679
Mailing Address - Street 1:1 S SCHOOL AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-6014
Mailing Address - Country:US
Mailing Address - Phone:941-365-8679
Mailing Address - Fax:
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:34237-6014
Practice Address - Country:US
Practice Address - Phone:941-365-8679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty