Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 20042082A | IN |
Y | 103TC0700X | Clinical Psychologist | 20042082A | IN |
NPI | 1003879859 |
---|---|
Provider Name | Dr. Franklin Edward Choate |
First Address | Rochester, IN 46975-0777 |
Second Address | Rochester, IN 46375-0777 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2006 |
Last Update Date | 25/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000483316 | ANTHEM (01) | |
200491360A | (05) | IN |
Q24551 | (02) |