Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 04-37395 | KS |
Y | 208600000X | Surgeon | 04-37395 | KS |
N | 2082S0105X | Plastic Hand Surgeon | 04-37395 | KS |
NPI | 1942469812 |
---|---|
Provider Name | Mr. Joshua David Linnell |
First Address | Wichita, KS 67206-3548 |
Second Address | Wichita, KS 67206-3548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 05/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201115610A | (05) | KS |