Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 04-30252 | KS |
NPI | 1104916857 |
---|---|
Provider Name | Dr. Rona K Gazaway |
First Address | Hutchinson, KS 67504-2294 |
Second Address | Hutchinson, KS 67502-1105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 12/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104750 | BCBSKS (01) | KS |
200331720A | (05) | KS |
8991 | PHS (01) | KS |
I31419 | (02) | KS |
P00231294 | RR MEDICARE (01) | KS |