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Individual

RANDALL L HOLCOMB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6286 BRIARCREST AVE, SUITE 200, MEMPHIS, TN 38120-4023
(901) 259-1600
(901) 259-2785
Mailing address
PO BOX 8888, BELFAST, ME 04915-8888
(901) 259-4260
(901) 259-2785

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
12265
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107443001
AR
05
110318002
AR
05
14670
MS
01
200022154
RAILROAD MEDICARE
TN
01
2614528
CIGNA
TN
05
3004063
TN
05
3371161
TN
01
4025293
AETNA
TN
01
620819926
BCBS
MS
01
620819926
AETNA
TN
05
7187860
MS
01
72209
BCBS
TN
Enumeration date
05/23/2005
Last updated
10/02/2012
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