Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 94-130 | NM |
NPI | 1043220478 |
---|---|
Provider Name | Thomas S Reich |
First Address | Artesia, NM 88211-0629 |
Second Address | Carlsbad, NM 88220-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 27/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A46486 | (02) |