Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD00014318 | WA |
NPI | 1023060357 |
---|---|
Provider Name | Ronald L Tokar |
First Address | Walla Walla, WA 99362 |
Second Address | Walla Walla, WA 99362-4363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A09392 | (02) | WA |