Provider Demographics
NPI:1912918848
Name:HOLT, WILLIAM P (DPM)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:HOLT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 KNOX RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2316
Mailing Address - Country:US
Mailing Address - Phone:865-687-7771
Mailing Address - Fax:865-688-6582
Practice Address - Street 1:312 KNOX RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2316
Practice Address - Country:US
Practice Address - Phone:865-687-7771
Practice Address - Fax:865-688-6582
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM116213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2008083OtherBCBS
TN3350096Medicaid
TN3350096Medicaid
TN3350096Medicare ID - Type Unspecified
TN2008083OtherBCBS