Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 11012817A | IN |
NPI | 1174781421 |
---|---|
Provider Name | Dr. Alexander Kirk Reichard |
First Address | Spokane, WA 99204-2715 |
Second Address | Spokane, WA 99204-2715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2008 |
Last Update Date | 04/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2013546 | (05) | WA |