Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 0102205158 | VA |
N | 207T00000X | Neurosurgeon | 2017010646 | MO |
NPI | 1023308368 |
---|---|
Provider Name | Jordan Joseph Synkowski |
First Address | Lynchburg, VA 24501-1400 |
Second Address | Lynchburg, VA 24501-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2011 |
Last Update Date | 17/07/2020 |