Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 11805466-1205 | UT |
Y | 208600000X | Surgeon | 11805466-1205 | UT |
N | 208200000X | Surgeon | 2013020688 | MO |
N | 208600000X | Surgeon | 2013020688 | MO |
N | 2086S0105X | Surgery of the Hand | 65469 | MN |
N | 2086S0122X | Plastic and Reconstructive Surgery | 65469 | MN |
NPI | 1417397019 |
---|---|
Provider Name | Dana Rioux Forker |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2013 |
Last Update Date | 16/11/2021 |