Healthcare Provider Details

I. General information

NPI: 1174557722
Provider Name (Legal Business Name): TERRY F HOLMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CARRIAGE HL
SIGNAL MOUNTAIN TN
37377-2355
US

IV. Provider business mailing address

44 CARRIAGE HILL
SIGNAL MOUNTAIN TN
37377
US

V. Phone/Fax

Practice location:
  • Phone: 423-774-3180
  • Fax:
Mailing address:
  • Phone: 423-265-2271
  • Fax: 423-785-3454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number25293
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD25293
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: