Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01041532 | IN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 01041532 | IN |
NPI | 1043244460 |
---|---|
Provider Name | Clem Melton Doxey |
First Address | Indianapolis, IN 46250-2805 |
Second Address | Indianapolis, IN 46250-2691 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 23/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100095160 | (05) | IN |
F27617 | (02) | IN |
P01133599 | MEDICARE RAILROAD (01) | IN |