Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 7456 | AZ |
NPI | 1053368308 |
---|---|
Provider Name | Eugene P. Falk |
First Address | Tucson, AZ 85745-2696 |
Second Address | Tucson, AZ 85745-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 30/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
208084 | (05) | AZ |
D36822 | (02) | AZ |