Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 14391 | NE |
NPI | 1033161625 |
---|---|
Provider Name | Joel T Cotton |
First Address | Omaha, NE 68114-3321 |
Second Address | Omaha, NE 68114-3321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0984948 | (05) | IA |
E38116 | (02) |