Provider Demographics
NPI:1720068190
Name:MARCHMAN, HOLMES BAKER (MD)
Entity type:Individual
Prefix:
First Name:HOLMES
Middle Name:BAKER
Last Name:MARCHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:655 JESSE JEWELL PKWY SE
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3756
Practice Address - Country:US
Practice Address - Phone:770-536-6300
Practice Address - Fax:770-536-6006
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037021208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10045238OtherAMERIGROUP
GA250006460OtherRR MEDICARE-GRP # CC4177
GA340872OtherWELLCARE
GA000542462BMedicaid
GA4502072OtherAETNA
GA52451378OtherBCBS
GA2300300OtherUNITED HEALTHCARE
GA000542462DMedicaid
GA4783129OtherCIGNA
GA52451378OtherBCBS
GA2300300OtherUNITED HEALTHCARE