Provider Demographics
NPI:1487819124
Name:WILLIAM E HOLCOMB MD & ASSOCIATES, PC
Entity Type:Organization
Organization Name:WILLIAM E HOLCOMB MD & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-739-3605
Mailing Address - Street 1:1890 AL HIGHWAY 157
Mailing Address - Street 2:STE 410
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-0689
Mailing Address - Country:US
Mailing Address - Phone:256-769-3605
Mailing Address - Fax:
Practice Address - Street 1:7 12TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1977
Practice Address - Country:US
Practice Address - Phone:256-739-3605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13470207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051512916OtherMEDICARE
ALJ244OtherMEDICARE GROUP
ALE35118Medicare UPIN
AL1427037605Medicare NSC