Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 390 | NE |
NPI | 1275526238 |
---|---|
Provider Name | Dr. Allen A Sossan |
First Address | Norfolk, NE 68701-3261 |
Second Address | Norfolk, NE 68701-3261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 12/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025272500 | (05) | NE |
6402460 | (05) | SD |
H32127 | (02) | NE |