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General NPI Number Information
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NPI Number | 1093160582
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Entity Type | Individual
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Provider Name | TIMOTHY SCOTT HOLCOMB PA
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Gender | Male
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Dates
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Enumeration Date | 05/03/2016
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 125 HOSPITAL DR BLUE RIDGE REGIONAL HOSPITAL
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City | SPRUCE PINE
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State | NC
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Zip | 28777-3035
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Country | US
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Telephone | 828-766-3755
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2125
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City | BANNER ELK
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State | NC
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Zip | 28604-2125
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Country | US
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Telephone | 828-260-5782
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NC
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