Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35091939 | OH |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 35091939 | OH |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35091939 | OH |
NPI | 1801058441 |
---|---|
Provider Name | Carlos Eduardo Gomez Orozco |
First Address | Bowling Green, OH 43402-1600 |
Second Address | Bowling Green, OH 43402-2650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2008 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2863487 | (05) | OH |