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General NPI Number Information
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NPI Number | 1124099437
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Entity Type | Individual
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Provider Name | THOMAS J HOLCOMB III MD
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 888 SWIFT BLVD.
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City | RICHLAND
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State | WA
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Zip | 99352-3514
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Country | US
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Telephone | 509-942-2931
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Fax |
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Provider Business Mailing Address
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Address Line | 427 COLUMBIA POINT DR.
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City | RICHLAND
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State | WA
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Zip | 99352-4373
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Country | US
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Telephone | 901-299-9644
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 16236
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 60187979
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License Number State | WA
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