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 | 363L00000X | Nurse Practitioner | | | | No |
| 2 | 174400000X | Specialist | | | | No |
| 3 | 207X00000X | Orthopaedic Surgery | | | | No |
| 4 | 207RX0202X | Internal Medicine | Medical Oncology | | | No |
| 5 | 208200000X | Plastic Surgery | | | | No |
| 6 | 207WX0200X | Ophthalmology | Ophthalmic Plastic and Reconstructive Surgery | | | No |
| 7 | 207RG0100X | Internal Medicine | Gastroenterology | | | No |
| 8 | 207P00000X | Emergency Medicine | | | | No |
| 9 | 363A00000X | Physician Assistant | | | | No |
| 10 | 207T00000X | Neurological Surgery | | | | No |
| 11 | 208600000X | Surgery | | | | No |
| 12 | 207RH0003X | Internal Medicine | Hematology & Oncology | | | No |
| 13 | 133V00000X | Dietitian, Registered | | | | No |
| 14 | 152W00000X | Optometrist | | | | No |
| 15 | 207R00000X | Internal Medicine | | | | Yes |