Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 50270 | TN |
NPI | 1043553761 |
---|---|
Provider Name | Mr. Julian Simon Winocour |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q029918 | (05) | TN |