Provider Demographics
NPI:1477519544
Name:HOLCOMB FACIAL PLASTIC SURGERY, P.L.
Entity Type:Organization
Organization Name:HOLCOMB FACIAL PLASTIC SURGERY, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
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:941-365-8680
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:941-365-8680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME800172082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1993Medicare PIN