Provider Demographics
NPI:1487665329
Name:WILLIAM P. HOLT, DPM
Entity Type:Organization
Organization Name:WILLIAM P. HOLT, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:865-687-7771
Mailing Address - Street 1:312 KNOX RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2316
Mailing Address - Country:US
Mailing Address - Phone:865-687-7771
Mailing Address - Fax:865-688-6582
Practice Address - Street 1:312 KNOX RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2316
Practice Address - Country:US
Practice Address - Phone:865-687-7771
Practice Address - Fax:865-688-6582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM116332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ021039Medicaid
TN3350096Medicaid
TN3350096Medicaid
TNT61047Medicare UPIN
TN0528930001Medicare NSC