Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 02000728A | IN |
NPI | 1225238603 |
---|---|
Provider Name | Dr. Tamzon Donna Feeney |
First Address | Indianapolis, IN 46228-1712 |
Second Address | Indianapolis, IN 46228-1712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 25/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02000728 | OSTEOPATHIC PHYSICIAN LICENSE (01) | IN |
AR9685302 | DEA (01) | IN |