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General NPI Number Information
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NPI Number | 1316042757
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Entity Type | Individual
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Provider Name | BRIAN GENE HOLCOMB DPM
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 620 J L WHITE DR STE 100
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City | JASPER
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State | GA
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Zip | 30143-4897
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Country | US
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Telephone | 706-692-6980
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Fax | 770-889-9547
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Provider Business Mailing Address
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Address Line | 3444 GREEN APPLE RD
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City | GAINESVILLE
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State | GA
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Zip | 30506-4121
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Country | US
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Telephone | 770-889-9596
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Fax | 770-889-9547
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD000536
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License Number State | GA
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