Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 24755 | TN |
NPI | 1013911882 |
---|---|
Provider Name | Dr. Danny J Strange |
First Address | Cookeville, TN 38503-0938 |
Second Address | Cookeville, TN 38501-4294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 22/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3044524 | (05) | TN |
3086582 | (05) | TN |
3100064 | BCBS OF TN (01) | TN |
F57270 | (02) |