Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 25735 | OK |
N | 208600000X | Surgeon | 25735 | OK |
N | 208800000X | Urologist | 48132 | TN |
Y | 208800000X | Urologist | 48421 | KY |
NPI | 1053517359 |
---|---|
Provider Name | Troy Michael Sofinowski |
First Address | Murfreesboro, TN 37129-2598 |
Second Address | Prestonsburg, KY 41653-9113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2007 |
Last Update Date | 07/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100491170 | (05) | KY |