Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 28951 | OK |
N | 207T00000X | Neurosurgeon | 34144 | NC |
NPI | 1083649867 |
---|---|
Provider Name | Allan Gregory Rosenfeld |
First Address | Tulsa, OK 74104-5649 |
Second Address | Tulsa, OK 74104-5649 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 21/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8973201 | (05) | NC |
B59997 | (02) | |
BR2733168 | DEA (01) |