Provider Demographics
NPI:1043471329
Name:HOLT, LYNLEY S (MD)
Entity type:Individual
Prefix:
First Name:LYNLEY
Middle Name:S
Last Name:HOLT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2097 LANGHORNE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1443
Mailing Address - Country:US
Mailing Address - Phone:434-947-5210
Mailing Address - Fax:434-947-5213
Practice Address - Street 1:550 WHITE OAK ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4710
Practice Address - Country:US
Practice Address - Phone:336-625-1360
Practice Address - Fax:336-625-1889
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2011-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2011-00384207Q00000X
VA0116020530207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2011-00384OtherNC STATE LICENSE