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 | | | | No |
| 2 | 101YA0400X | Counselor | Addiction (Substance Use Disorder) | | | No |
| 3 | 207P00000X | Emergency Medicine | | | | No |
| 4 | 282N00000X | General Acute Care Hospital | | | | No |
| 5 | 207R00000X | Internal Medicine | | | | No |
| 6 | 261QM1200X | Clinic/Center | Magnetic Resonance Imaging (MRI) | | | No |
| 7 | 261QM1300X | Clinic/Center | Multi-Specialty | | | No |
| 8 | 213E00000X | Podiatrist | | | | No |
| 9 | 208800000X | Urology | | | | No |
| 10 | 207V00000X | Obstetrics & Gynecology | | | | No |
| 11 | 324500000X | Substance Abuse Rehabilitation Facility | | | | No |
| 12 | 207XX0005X | Orthopaedic Surgery | Sports Medicine | | | No |
| 13 | 207N00000X | Dermatology | | | | No |
| 14 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 15 | 208D00000X | General Practice | | | | Yes |