Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 24961 | OK |
NPI | 1013939800 |
---|---|
Provider Name | Joel Nathan Abramovitz |
First Address | Tulsa, OK 74104-5649 |
Second Address | Tulsa, OK 74104-5649 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 13/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200089670A | (05) | OK |
A67553 | (02) | OK |