Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | KY6886 | KY |
NPI | 1003971128 |
---|---|
Provider Name | Dr. Gregory Keith Inman |
First Address | Elizabethtown, KY 42701-1874 |
Second Address | Elizabethtown, KY 42701-1874 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 08/07/2007 |