Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 14341 | AZ |
NPI | 1134337918 |
---|---|
Provider Name | Dr. Thomas Frederick Disney |
First Address | Phoenix, AZ 85028-1511 |
Second Address | Phoenix, AZ 85028-1511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |