Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35082522 | OH |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 35082522 | OH |
NPI | 1003983743 |
---|---|
Provider Name | Dr. Robert Todd Gorsline |
First Address | Hilliard, OH 43026-2496 |
Second Address | Hilliard, OH 43026-2496 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 15/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000578479 | ANTHEM (01) | |
4421123 | AETNA (01) | OH |