Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 2306951 | NY |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | D0063386 | MD |
Y | 2081P2900X | Pain Medicine | 2008-00005 | NC |
NPI | 1124036694 |
---|---|
Provider Name | Dr. Alvin K Antony |
First Address | Rocky Mount, NC 27804-0129 |
Second Address | Rocky Mount, NC 27804-8761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 12/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
140405 | (02) | |
5909282 | (05) | NC |