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General NPI Number Information
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NPI Number | 1356546790
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Entity Type | Individual
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Provider Name | TIMOTHY RYAN HOLMES D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2007
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 1030 REFUGEE RD SUITE 295
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City | PICKERINGTON
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State | OH
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Zip | 43147-9755
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Country | US
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Telephone | 614-545-4321
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Fax | 614-545-4324
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Provider Business Mailing Address
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Address Line | 1045 BEECHER XING N SUITE A
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City | GAHANNA
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State | OH
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Zip | 43230-4573
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Country | US
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Telephone | 614-304-0019
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Fax | 614-304-0023
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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 | 36.003465
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License Number State | OH
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