MEDICARE: LORIN G HOLST 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
1	207RA0401X	Addiction Medicine (Internal Medicine) Physician	35814	TN

General Provider Information

NPI Number	:	1598859894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORIN G HOLST MD

Provider Business Mailing Address
First Line	:	1909 CEDARDALE LN
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37932-1549
Country	:	US
Telephone Number	:	865-414-5221
Fax Number	:

Provider Business Practice Location Address
First Line	:	930 ADELL REE PARK LN
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2543
Country	:	US
Telephone Number	:	865-769-2600
Fax Number	:	865-769-2616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	02/23/2017

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