Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 0101236220 | VA |
NPI | 1023205739 |
---|---|
Provider Name | Kinloch Nelson |
First Address | Richmond, VA 23235 |
Second Address | Richmond, VA 23235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2007 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010111064 | (05) | VA |
309085 | CIGNA (01) | |
7389525 | AETNA (01) | |
I05898 | (02) | VA |