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General NPI Number Information
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NPI Number | 1942297858
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Entity Type | Individual
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Provider Name | KEVIN H HOLMES M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 912 SUMRALL RD
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City | COLUMBIA
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State | MS
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Zip | 39429-2652
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Country | US
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Telephone | 601-736-6443
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Fax | 601-736-2543
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Provider Business Mailing Address
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Address Line | 104 PARTNERSHIP WAY
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City | COLUMBIA
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State | MS
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Zip | 39429-4502
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Country | US
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Telephone | 601-736-6443
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Fax | 601-736-4641
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 15453
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License Number State | MS
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