Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 35.137242 | OH |
N | 2081P2900X | Pain Medicine | 45525 | KY |
NPI | 1548519614 |
---|---|
Provider Name | Carlene Westfall |
First Address | College Corner, OH 45003-0641 |
Second Address | College Corner, OH 45003-9061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2012 |
Last Update Date | 01/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100230570 | (05) | KY |