Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 45134 | KY |
N | 207RX0202X | Medical Oncology | ME 100326 | FL |
NPI | 1114919925 |
---|---|
Provider Name | Dr. Francis M Domurat |
First Address | Corbin, KY 40702-1410 |
Second Address | Corbin, KY 40701-8727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 31/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100195430 | (05) | KY |
B72280 | (02) | AK |
K037680 | MEDICARE PTAN (01) | KY |
MD4172 | (05) | AK |
P01074854 | RAILROAD MEDICARE PTAN (01) | KY |