Provider Demographics
NPI:1396127155
Name:HOLMES, KATELIN TURNER (DO)
Entity type:Individual
Prefix:
First Name:KATELIN
Middle Name:TURNER
Last Name:HOLMES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATELIN
Other - Middle Name:ANNE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:4160 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3638
Practice Address - Country:US
Practice Address - Phone:334-747-7440
Practice Address - Fax:334-747-7449
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25452086X0206X
OH34.0144092086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBP10053238OtherPIT #
OH34.014409OtherMEDICAL LICENSE
TXBP20069762OtherPIT #
ALDO.2545OtherMEDICAL LICENSE