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 | 207LP2900X | Anesthesiology | Pain Medicine | | | No |
| 2 | 207P00000X | Emergency Medicine | | | | Yes |
| 3 | 207RA0000X | Internal Medicine | Adolescent Medicine | | | No |
| 4 | 207RP1001X | Internal Medicine | Pulmonary Disease | | | No |
| 5 | 207XS0114X | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | | | No |
| 6 | 207XS0117X | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | | | No |
| 7 | 207XX0004X | Orthopaedic Surgery | Foot and Ankle Surgery | | | No |
| 8 | 207XX0005X | Orthopaedic Surgery | Sports Medicine | | | No |
| 9 | 2084N0400X | Psychiatry & Neurology | Neurology | | | No |
| 10 | 2084P0301X | Psychiatry & Neurology | Brain Injury Medicine | | | No |
| 11 | 261QM1300X | Clinic/Center | Multi-Specialty | | | No |
| 12 | 261QM2500X | Clinic/Center | Medical Specialty | | | No |