Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 011745 | LA |
NPI | 1427080738 |
---|---|
Provider Name | Dr. Kenneth W Falterman |
First Address | Baton Rouge, LA 70816-6038 |
Second Address | Lafayette, LA 70508-6908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 21/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1195197 | (05) | LA |