Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207Q00000X | Family Medicine | | 48476-020 | WISCONSIN | No |
| 2 | 2083X0100X | Preventive Medicine | Occupational Medicine | 22259 | WEST VIRGINIA | No |
| 3 | 2083X0100X | Preventive Medicine | Occupational Medicine | 48476-20 | WISCONSIN | No |
| 4 | 2083X0100X | Preventive Medicine | Occupational Medicine | M7328 | TEXAS | Yes |
| 5 | 207Q00000X | Family Medicine | | M7328 | TEXAS | No |
| 6 | 207Q00000X | Family Medicine | | 22259 | WEST VIRGINIA | No |