Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 30133 | AL |
N | 208000000X | Pediatrician | 41130 | IA |
N | 208000000X | Pediatrician | 81943 | AZ |
Y | 2080P0208X | Pediatric Infectious Diseases | 41130 | IA |
NPI | 1275709586 |
---|---|
Provider Name | Nathan Brandt Price |
First Address | Tucson, AZ 85724-5073 |
Second Address | Tucson, AZ 85724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2008 |
Last Update Date | 01/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
119085 | (05) | AL |
81943 | ARIZONA MEDICAL BOARD (01) | AZ |