Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | VA |
NPI | 1306981444 |
---|---|
Provider Name | Dr. Ronald Lee Todd |
First Address | Lynchburg, VA 24501-1009 |
Second Address | Lynchburg, VA 24501-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U27971 | (02) | VA |