Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 04-23214 | KS |
Y | 2082S0105X | Plastic Hand Surgeon | R7J00 | MO |
NPI | 1225034531 |
---|---|
Provider Name | Dr. Dana R Towle |
First Address | Kansas City, MO 64116-1507 |
Second Address | Kansas City, MO 64116-1507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 04/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
203043914 | (05) | MO |
E60374 | (02) |