Healthcare Provider Details

I. General information

NPI: 1205215399
Provider Name (Legal Business Name): SCOTT DANIEL HOLT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 N WESTOVER BLVD
ALBANY GA
31707-2188
US

IV. Provider business mailing address

605 N WESTOVER BLVD
ALBANY GA
31707-2188
US

V. Phone/Fax

Practice location:
  • Phone: 229-513-4579
  • Fax: 229-434-1488
Mailing address:
  • Phone: 229-513-4579
  • Fax: 229-434-1488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number88999
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: