Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 01052068 | IN |
NPI | 1275530602 |
---|---|
Provider Name | Douglas Alan Flory |
First Address | Indianapolis, IN 46237-8561 |
Second Address | Indianapolis, IN 46237-8561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 01/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200272920 | (05) | IN |
G34814 | (02) |