Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 30018377 | OH |
NPI | 1104844554 |
---|---|
Provider Name | Dr. Larry D. Towning |
First Address | Zanesville, OH 43701-1664 |
Second Address | Zanesville, OH 43701-6420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0811769 | (05) | OH |