Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 04-31437 | KS |
N | 207QS0010X | Family Doctor - Sports Medicine | 0431437 | KS |
NPI | 1285681775 |
---|---|
Provider Name | Dr. Joseph B Noland |
First Address | Shawnee, KS 66217-9414 |
Second Address | Shawnee, KS 66217-9414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 06/12/2012 |