Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 7766 | ND |
NPI | 1184720948 |
---|---|
Provider Name | D'arcy Adaire Honeycutt |
First Address | Bismarck, ND 58501-4463 |
Second Address | Bismarck, ND 58501-4463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
29333 | KY STATE MEDICAL LICENSE (01) | KY |
E10098 | (02) | |
H0460 | TX STATE MEDICAL LICENSE (01) | TX |