Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 22709 | IA |
NPI | 1043262181 |
---|---|
Provider Name | Dr. Ashok K Nakhasi |
First Address | Waterloo, IA 50702-5619 |
Second Address | Waterloo, IA 50702-5619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0287904 | (05) | IA |
185629 | BCBS (01) | IA |
A01843 | (02) | IA |