Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD2008-0206 | NM |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD2008-0206 | NM |
NPI | 1407020597 |
---|---|
Provider Name | Joshua T Carothers |
First Address | Albuquerque, NM 87106-4917 |
Second Address | Albuquerque, NM 87106-4917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 11/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
66803764 | (05) | NM |