Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 02000967A | IN |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 036.073224 | IL |
NPI | 1447288303 |
---|---|
Provider Name | Dr. Thomas E. Turcotte JR. |
First Address | Dixon, IL 61021 |
Second Address | Dixon, IL 61021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 24/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100367750A | (05) | IN |
D16245 | (02) | IN |