Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | M6980 | TX |
N | 207VX0000X | Obstetrician | M6980 | TX |
NPI | 1396957155 |
---|---|
Provider Name | David Clark Kerr |
First Address | Snyder, TX 79549-6162 |
Second Address | Snyder, TX 79549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 14/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
188260703 | (05) | TX |