Holt, Jacob Eric Ronald

Holt, Jacob Eric Ronald is an individual health care provider with primary practice located at 119 Boone Ridge Dr Suite 201, Johnson City TN 37615-4998. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Holt, Jacob Eric Ronald can be contacted via phone (423) 282-1480.

Contact Information

Primary practice address
119 Boone Ridge Dr Suite 201 Johnson City TN 37615-4998
Phone: (423) 282-1480
Fax: (423) 928-1353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 42090 Tennessee
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 42090 Tennessee
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 42866 Colorado

Profile Details

NPI number 1194831636
LBN Legal business name Holt, Jacob Eric Ronald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2006
Last updated May 8th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194831636 NPPES
Colorado MEDICAID 73375039
Colorado MEDICAID 3000017

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