Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 07000766A | IN |
NPI | 1104862820 |
---|---|
Provider Name | Dr. Thomas Kenneth Hupfer |
First Address | Evansville, IN 47716-0454 |
Second Address | Evansville, IN 47714-0106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 26/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100121220 | (05) | IN |
7338450001 | DME (01) | IN |