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NPI Code Detail

MEDICARE: DR. EDWIN MICHAEL HOLT M.D.

MEDICARE: DR. EDWIN MICHAEL HOLT M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianMD15020TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10200029382OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TN0179OTHERTNJOHN DEERE HEALTHCARE
2100021361OTHERTNTENNCARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
40940098OTHERTNUNITED HEALTH CARE
54664609OTHERTNAETNA
6TN0105OTHERTNJOHN DEERE HEALTHCARE
73071402OTHERTNBLUE CROSS BLUE SHIELD
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9TN0106OTHERTNJOHN DEERE HEALTHCARE

General Provider Information

NPI Number : 1104893148
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWIN MICHAEL HOLT M.D.
Provider Business Mailing Address
First Line : 1600 ACCELERATOR WAY STE 200
Second Line :
City : KNOXVILLE
State : TN
Zip : 37920-3078
Country : US
Telephone Number : 865-546-2663
Fax Number : 865-546-9047
Provider Business Practice Location Address
First Line : 1600 ACCELERATOR WAY STE 200
Second Line :
City : KNOXVILLE
State : TN
Zip : 37920-3078
Country : US
Telephone Number : 865-546-2663
Fax Number : 865-546-9047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 06/02/2022

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