Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD57830 | TN |
NPI | 1063671493 |
---|---|
Provider Name | David D Lo |
First Address | Knoxville, TN 37950-2948 |
Second Address | Knoxville, TN 37919-4858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 24/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q037752 | (05) | TN |