Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 56231 | GA |
N | 207PE0004X | Emergency Medical Services | 56231 | GA |
NPI | 1053393637 |
---|---|
Provider Name | Dr. Kevin D. Toon |
First Address | Athens, GA 30604-5719 |
Second Address | Athens, GA 30606-2797 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H29635 | (02) |