Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 4428 | OK |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | N5838 | TX |
NPI | 1184825994 |
---|---|
Provider Name | Samuel Scott Maroney |
First Address | Tuscola, TX 79562-3917 |
Second Address | Abilene, TX 79606-5209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 16/06/2010 |