Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 19327 | OK |
N | 208200000X | Surgeon | 19327 | OK |
N | 208600000X | Surgeon | 19327 | OK |
NPI | 1295759215 |
---|---|
Provider Name | Dr. Anthony Sebastian |
First Address | Denver, CO 80237-3486 |
Second Address | Oklahoma City, OK 73104-5099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 11/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100005140A | (05) | OK |