Healthcare Provider Details

I. General information

NPI: 1043205669
Provider Name (Legal Business Name): JOEL HOLCOMBE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 THOMASVILLE ROAD PHYSICIAN BILLING OFFICE
TALLAHASSEE FL
32303
US

IV. Provider business mailing address

1300 MICCOSUKEE ROAD BIXLER EMERGENCY CENTER
TALLAHASSEE FL
32308
US

V. Phone/Fax

Practice location:
  • Phone: 850-431-7289
  • Fax: 850-431-6975
Mailing address:
  • Phone: 850-431-0911
  • Fax: 850-431-0779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number049405
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME119322
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: