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General NPI Number Information
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NPI Number | 1760462089
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Entity Type | Individual
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Provider Name | KIRK S HOLSTON DPM
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Gender | Male
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 6002 E 38TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-5614
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Country | US
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Telephone | 317-880-6002
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Fax | 317-880-0417
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Provider Business Mailing Address
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Address Line | PO BOX 637764
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City | CINCINNATI
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State | OH
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Zip | 45263-7764
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Country | US
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Telephone | 317-880-3939
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 05001328A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 070000768A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 070000768A
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License Number State | IN
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