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NPI Code Detail

MEDICARE: LEWIS HENRY HOLMES III MD

MEDICARE: LEWIS HENRY HOLMES III MD
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
1207R00000XInternal Medicine Physician41157TN
2208M00000XHospitalist Physician41157TN
3174400000XSpecialist41157TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
141157OTHERTNLICENSE NUMBER

General Provider Information

NPI Number : 1134173768
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEWIS HENRY HOLMES III MD
Provider Business Mailing Address
First Line : 1021 W OAKLAND AVE STE 310
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-2192
Country : US
Telephone Number : 423-952-2111
Fax Number :
Provider Business Practice Location Address
First Line : 1420 TUSCULUM BLVD
Second Line :
City : GREENEVILLE
State : TN
Zip : 37745-4279
Country : US
Telephone Number : 423-787-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 12/12/2025

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