Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 125064864 | IL |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | TP448 | KY |
NPI | 1477966216 |
---|---|
Provider Name | Dr. David Cooper Landy |
First Address | Chicago, IL 60637-1447 |
Second Address | Lexington, KY 40508-2678 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2014 |
Last Update Date | 06/08/2020 |