Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ME0015334 | FL |
N | 207YS0123X | Facial Plastic Surgeon | 11287 | AL |
NPI | 1558344515 |
---|---|
Provider Name | Dr. John L Pallin |
First Address | Pensacola, FL 32514-6050 |
Second Address | Foley, AL 36535-2248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B61912 | (02) |