Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 06370 | IA |
NPI | 1952347809 |
---|---|
Provider Name | Dr. Preston Hutchins Tornell |
First Address | Sioux City, IA 51104-1546 |
Second Address | Sioux City, IA 51104-1546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0230375 | (05) | IA |