Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 45999 | KY |
Y | 208600000X | Surgeon | 45999 | KY |
N | 208200000X | Surgeon | G71398 | CA |
N | 208600000X | Surgeon | G71398 | CA |
N | 208200000X | Surgeon | MD048605L | PA |
N | 208600000X | Surgeon | MD048605L | PA |
N | 2086S0129X | Vascular Surgeon | MD0000037623 | TN |
N | 2086S0129X | Vascular Surgeon | MD048605L | PA |
NPI | 1134295124 |
---|---|
Provider Name | Dr. Thomas W Unruh |
First Address | Russellville, KY 42276-1520 |
Second Address | Russellville, KY 42276-8889 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F44375 | (02) | TN |