Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2003007011 | MO |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 2003007011 | MO |
NPI | 1356334932 |
---|---|
Provider Name | David E Hockman |
First Address | Columbia, MO 65201-7199 |
Second Address | Columbia, MO 65201-7199 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2005 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
209074707 | (05) | MO |
H72389 | (02) | MO |