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General NPI Number Information
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NPI Number | 1992708895
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Entity Type | Individual
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Provider Name | MARK MANNING HOLT M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 2815 W ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-3216
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Country | US
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Telephone | 423-254-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 434 4TH ST STE 201
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City | NEWPORT
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State | TN
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Zip | 37821-3736
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Country | US
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Telephone | 865-647-5800
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Fax | 865-647-5979
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C53118
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD33994
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License Number State | TN
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