Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 24647 | CO |
NPI | 1023017845 |
---|---|
Provider Name | Dr. Joel Aloysius Ernster |
First Address | Colorado Springs, CO 80932-0190 |
Second Address | Colorado Springs, CO 80909-1177 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 16/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01246479 | (05) | CO |
D24485 | (02) | CO |