Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 35.035304 | OH |
Y | 111NI0900X | Internist | 35.035304 | OH |
N | 207U00000X | Nuclear Medicine Specialist | 35.035304 | OH |
NPI | 1437111309 |
---|---|
Provider Name | Dr. Harry Russell Maxon III |
First Address | Hilton Head Island, SC 29928-5601 |
Second Address | Cincinnati, OH 45206-4400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 23/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A75087 | (02) | OH |