Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 2170 | MS |
Y | 207KA0200X | Allergist | DO.1138 | AL |
N | 207R00000X | Internist | 20170 | MS |
N | 111NI0900X | Internist | 20170 | MS |
N | 207R00000X | Internist | DO.1138 | AL |
N | 111NI0900X | Internist | DO.1138 | AL |
NPI | 1568671584 |
---|---|
Provider Name | Dr. John Winchester Tole II |
First Address | Opelika, AL 36801-5449 |
Second Address | Opelika, AL 36801-5449 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03624302 | (05) | MS |