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 | 208800000X | Urology | | 8965 | OKLAHOMA | No |
| 2 | 208800000X | Urology | | 3796 | WEST VIRGINIA | No |
| 3 | 2088P0231X | Urology | Pediatric Urology | 89535 | SOUTH CAROLINA | No |
| 4 | 2088P0231X | Urology | Pediatric Urology | 00016648 | SOUTH DAKOTA | No |
| 5 | 208D00000X | General Practice | | 1260 | NEBRASKA | No |
| 6 | 171000000X | Military Health Care Provider | | | | Yes |