Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 12373 | AZ |
N | 208600000X | Surgeon | 12373 | AZ |
Y | 208200000X | Surgeon | G-16009 | CA |
Y | 208600000X | Surgeon | G-16009 | CA |
N | 208D00000X | General Practice Physician | 12373 | AZ |
N | 208D00000X | General Practice Physician | G-16009 | CA |
NPI | 1003087891 |
---|---|
Provider Name | Dr. Edward Thurston Paget |
First Address | Needles, CA 92363-3053 |
Second Address | Needles, CA 92363-3105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2008 |
Last Update Date | 12/02/2021 |