Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 28762 | KY |
NPI | 1144226598 |
---|---|
Provider Name | James P O'rourke |
First Address | Cincinnati, OH 45263-6961 |
Second Address | Paducah, KY 42003-7913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 16/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64287626 | (05) | KY |
A97334 | (02) | KY |