Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | BP10053238 | TX |
N | 208600000X | Surgeon | BP10053238 | TX |
Y | 2086X0206X | Surgical Oncologist | 34.014409 | OH |
NPI | 1396127155 |
---|---|
Provider Name | Katelin Turner Holmes |
First Address | Montgomery, AL 36106-3638 |
Second Address | Montgomery, AL 36106-3638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2015 |
Last Update Date | 09/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34.014409 | MEDICAL LICENSE (01) | OH |
BP10053238 | PIT # (01) | TX |
BP20069762 | PIT # (01) | TX |
DO.2545 | MEDICAL LICENSE (01) | AL |