Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | P2866 | TX |
N | 208200000X | Surgeon | 248029-1 | NY |
N | 208600000X | Surgeon | 248029-1 | NY |
Y | 208200000X | Surgeon | P2866 | TX |
Y | 208600000X | Surgeon | P2866 | TX |
N | 2086S0122X | Plastic and Reconstructive Surgery | 248029-1 | NY |
N | 2086S0122X | Plastic and Reconstructive Surgery | P2866 | TX |
NPI | 1164674651 |
---|---|
Provider Name | Dr. Nicholas Till Haddock |
First Address | Dallas, TX 75390 |
Second Address | Dallas, TX 75390 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2008 |
Last Update Date | 04/09/2012 |