Provider Demographics
NPI:1134239049
Name:HOLT, ANTHONY E (DO)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:E
Last Name:HOLT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3193
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29648-3193
Mailing Address - Country:US
Mailing Address - Phone:864-227-5240
Mailing Address - Fax:864-227-5239
Practice Address - Street 1:917 BYPASS 225 S
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-8025
Practice Address - Country:US
Practice Address - Phone:864-227-5240
Practice Address - Fax:864-227-5239
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDO1532204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC015325Medicaid
SCAA80905113Medicare PIN