Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DE00005568 | WA |
NPI | 1154300846 |
---|---|
Provider Name | Dr. Karl Kiyotaka Furukawa |
First Address | Fort Huachuca, AZ 85613-7040 |
Second Address | Fort Huachuca, AZ 85613-7040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 27/06/2016 |