Individual
KIRK S HOLSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6002 E 38TH ST, INDIANAPOLIS, IN 46226-5614
(317) 880-6002
(317) 880-0417
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
05001328A
IN
213E00000X
Podiatrist
070000768A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
070000768A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000364510
ANTHEM BCBS
IN
01
—
0005497063
AETNA
IN
05
—
100121880
—
IN
05
—
100121880A
—
IN
01
—
202158547
TRICARE
IN
01
—
P00284245
RR MCR
—
Enumeration date
01/20/2006
Last updated
09/22/2025
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