Provider Demographics
NPI:1467489286
Name:HOLMES, DAVID G (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:HOLMES
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 1:2601 VILLAGE PROFESSIONAL DR N
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-4784
Mailing Address - Country:US
Mailing Address - Phone:334-528-5400
Mailing Address - Fax:334-528-5421
Practice Address - Street 1:2601 VILLAGE PROFESSIONAL DR N
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4784
Practice Address - Country:US
Practice Address - Phone:334-528-5400
Practice Address - Fax:334-528-5421
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025379207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009911359Medicaid
AL009911583Medicaid
AL051006264OtherBCBS PROVIDER NUMBER
AL009911354Medicaid
AL009911356Medicaid
AL051006261OtherBCBS PROVIDER NUMBER
AL051006268OtherBCBS PROVIDER NUMBER
AL009911358Medicaid
AL1467489286OtherNPI
AL00911589Medicaid
AL009911586Medicaid
AL051006259OtherBCBS PROVIDER NUMBER
AL051006263OtherBCBS PROVIDER NUMBER
AL009911357Medicaid
AL009911587Medicaid
AL009911588Medicaid
AL009911361Medicaid
AL051006254OtherBC PROVIDER NUMBER
AL051006263OtherBCBS PROVIDER NUMBER
AL009911358Medicaid