Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD5034 | AL |
NPI | 1063467447 |
---|---|
Provider Name | John H Rand |
First Address | Tallassee, AL 36078 |
Second Address | Tallassee, AL 36078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 06/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009913154 | (05) | AL |
073949 | (05) | SC |
C68865 | (02) | SC |
GP3546 | (05) | SC |