Provider Demographics
NPI:1841203833
Name:HOLCOMBE, DEREK KEITH (MD)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:KEITH
Last Name:HOLCOMBE
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3368 HIGHWAY 280
Mailing Address - Street 2:SUITE 214
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3393
Mailing Address - Country:US
Mailing Address - Phone:256-329-2829
Mailing Address - Fax:256-329-9135
Practice Address - Street 1:3368 HIGHWAY 280 STE 107
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3375
Practice Address - Country:US
Practice Address - Phone:256-329-2829
Practice Address - Fax:256-329-9135
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2023-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL14800207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529603400Medicaid
AL100008592OtherRAILROAD MEDICARE
AL51028627OtherBLUE CROSS BLUE SHIELD