Provider Demographics
NPI:1518077858
Name:HOLCOMB, JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:HOLCOMB
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 1:81 MEDICAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-9835
Mailing Address - Country:US
Mailing Address - Phone:802-334-4120
Mailing Address - Fax:802-334-4123
Practice Address - Street 1:81 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9835
Practice Address - Country:US
Practice Address - Phone:802-334-4120
Practice Address - Fax:802-334-4123
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420005991207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0004701Medicaid
VT00004701OtherBLUE SHIELD
VT080063351OtherRAILROAD MEDICARE
VT323978OtherMVP
VT8000699OtherLADIES FIRST
VT323978OtherMVP
VT8000699OtherLADIES FIRST