MEDICARE: JEFFREY SCOTT HOLMES 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	207R00000X	Internal Medicine Physician	18551	WV

General Provider Information

NPI Number	:	1982665329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY SCOTT HOLMES MD

Provider Business Mailing Address
First Line	:	1100 GROSSCUP AVE
Second Line	:
City	:	DUNBAR
State	:	WV
Zip	:	25064-3120
Country	:	US
Telephone Number	:	304-768-8811
Fax Number	:	304-768-4072

Provider Business Practice Location Address
First Line	:	3752 TEAYS VALLEY RD
Second Line	:
City	:	HURRICANE
State	:	WV
Zip	:	25526-9705
Country	:	US
Telephone Number	:	304-757-3131
Fax Number	:	304-757-7718

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	11/17/2025

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