Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 23103 | WV |
N | 207T00000X | Neurosurgeon | MD.010050 | LA |
NPI | 1043278450 |
---|---|
Provider Name | Dr. Richard A. Coulon |
First Address | Huntington, WV 25701-3656 |
Second Address | Huntington, WV 25701-3656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 19/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1142166 | (05) | LA |
2837130 | (05) | OH |
3810011593 | (05) | WV |
7100046240 | (05) | KY |
B61586 | (02) |