Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 5017-015 | WI |
NPI | 1043266927 |
---|---|
Provider Name | Christopher S. Mcfarlane |
First Address | Oshkosh, WI 54902 |
Second Address | Oshkosh, WI 54902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 07/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U91475 | (02) | WI |