Provider Demographics
NPI:1669940052
Name:SPIRES, EMILY HOLCOMB (CPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:HOLCOMB
Last Name:SPIRES
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 SHALIMAR POINT DR
Mailing Address - Street 2:
Mailing Address - City:SHALIMAR
Mailing Address - State:FL
Mailing Address - Zip Code:32579-1653
Mailing Address - Country:US
Mailing Address - Phone:865-209-4987
Mailing Address - Fax:
Practice Address - Street 1:2018 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-5718
Practice Address - Country:US
Practice Address - Phone:865-544-0406
Practice Address - Fax:865-544-0480
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2023-07-28
Deactivation Date:2023-07-11
Deactivation Code:
Reactivation Date:2023-07-28
Provider Licenses
StateLicense IDTaxonomies
246RP1900X
FL9117238363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy