Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | L3723F | AL |
NPI | 1003153834 |
---|---|
Provider Name | Jan Kenjiro Vonhoegen |
First Address | Birmingham, AL 35233-2414 |
Second Address | Birmingham, AL 35213-1964 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2013 |
Last Update Date | 14/01/2013 |