Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 17277 | OK |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 17277 | OK |
NPI | 1043218381 |
---|---|
Provider Name | Paul Alan Kammerlocher |
First Address | Oklahoma City, OK 73114-7408 |
Second Address | Oklahoma City, OK 73114-7408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 22/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100825150C | (05) | OK |
200034662 | (05) | OK |
F88932 | (02) |