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Individual
KENNETH L HOLBERT
Active
Individual
KENNETH L HOLBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21847
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3045786
BLUE CROSS
TN
01
—
3051807
BLUE CROSS
TN
01
—
3062431
BLUE CROSS
TN
05
—
3073132
—
TN
05
—
3073134
—
TN
05
—
3333055
—
TN
01
—
37513
TLC TENNCARE
TN
01
—
5001148
TLC TENNCARE
TN
01
—
532950
OMNICARE TENNCARE
TN
01
—
P00259801
MEDICARE RAILROAD
TN
01
—
P00297030
MEDICARE RAILROAD
TN
Enumeration date
05/27/2006
Last updated
11/06/2007
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