Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 16907 | MS |
NPI | 1013921642 |
---|---|
Provider Name | Dr. Danett Maples |
First Address | Columbus, MS 39703-1806 |
Second Address | Columbus, MS 39705-2008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 24/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
302I054030 | (02) | MS |