Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 036127369 | IL |
NPI | 1417096090 |
---|---|
Provider Name | Dr. Nathan David Joos |
First Address | Springfield, IL 62703-2403 |
Second Address | Springfield, IL 62703-2403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 22/05/2020 |