Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD467812 | PA |
NPI | 1043571144 |
---|---|
Provider Name | Dr. Jeffrey Thorne |
First Address | King Of Prussia, PA 19406-1438 |
Second Address | King Of Prussia, PA 19406-1438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 22/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD467812 | MD LICENSE (01) | PA |