Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2009-01310 | NC |
Y | 208600000X | Surgeon | 2009-01310 | NC |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD418843 | PA |
NPI | 1275506362 |
---|---|
Provider Name | Dr. Jeffrey John Pokorny |
First Address | Elizabeth City, NC 27909-3354 |
Second Address | Elizabeth City, NC 27909-3354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 21/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0019044240002 | (05) | PA |
02285858 | (05) | NY |
H70125 | (02) |