Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 30632 | KY |
Y | 208600000X | Surgeon | 30632 | KY |
N | 2086S0105X | Surgery of the Hand | 30632 | KY |
N | 2086S0122X | Plastic and Reconstructive Surgery | 30632 | KY |
NPI | 1164441275 |
---|---|
Provider Name | Dr. Daniel M Tkach |
First Address | Paducah, KY 42003-3827 |
Second Address | Paducah, KY 42003-3827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 24/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000200472 | BLUE CROSS (01) | KY |
164277500 | US DEPT OF LABOR (01) | |
240006752 | RAILROAD MEDICARE (01) | |
64306327 | (05) | KY |
F84448 | (02) |