Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 01041306A | IN |
Y | 207VX0000X | Obstetrician | 01041306A | IN |
NPI | 1245292341 |
---|---|
Provider Name | Dr. Thomas Patrick O'rourke |
First Address | Vincennes, IN 47591-3865 |
Second Address | Vincennes, IN 47591-1029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 25/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10015520A | (05) | IN |
F58661 | (02) | IN |