Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 0101257891 | VA |
NPI | 1093991275 |
---|---|
Provider Name | Judy Ko |
First Address | Fishersville, VA 22939-0388 |
Second Address | Lexington, VA 24450-3789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2008 |
Last Update Date | 03/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093991275 | (05) | VA |