Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 22720 | NE |
NPI | 1033101878 |
---|---|
Provider Name | Timothy C Kuo |
First Address | Fremont, NE 68025-2414 |
Second Address | Fremont, NE 68025-2414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 03/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025098000 | (05) | NE |
H42903 | (02) | NE |